One of the major advances that has allowed cornea (and therefore vision) to be restored, the last years, has been partial corneal trasplantation or stell cell transplantation. In IMO Miranza Group, we carry out important research projects, lead by IMO Foundation, with the objective to find a solution or improve the prognosis of patients suffering from diseases or injuries of the cornea.
Corneal transplant: when is it done?
Corneal transplantation is a surgical procedure performed on patients with damage to this area of the eye as a result of an accident or diseases that cause certain opacities or changes in their shape, for example, in severe cases of keratoconus. In this sense, “the main goal of this intervention is to heal or improve the patient's vision, and for this we completely or partially transplant the damaged cornea, replacing it with a healthy one,” explains Dr. Óscar Gris, specialist in various corneal transplantation techniques.
Transplanting just part of the cornea
There are several surgical techniques that can be used for corneal transplants, adds Dr. Gris: “We can replace the front or back, depending on each patient. One of the most widespread techniques - DMEK - is an endothelial transplant of Descemet's membrane, which we started using more than ten years ago with very good results. "
Currently, more than 50% of our corneal transplants are performed using the DMEK technique, as we have many patients with problems in this area called the endothelium.
Dr. Óscar Gris
A safe surgery, performed by experts
One of the great advantages of DMEK is that it is less invasive. “In addition, the patient's recovery period is shorter, their prognosis is much better and there are fewer postoperative complications in the short as well as the long term.”. “In most cases, our operated patients recover 95% of their vision, and the risk of rejection of the transplant is very low (less than 3%) ", continues Dr. Gris. However, as the expert notes, it is important to emphasize that:" Not all patients are candidates for this type of intervention and it is necessary to do an ophthalmological examination in advance and evaluate whether this is the best option".
It is very important to trust experienced ophthalmology experts who specialize in this type of procedure so that you can also avoid possible complications.
Dr. Óscar Gris
Corneal stem cell transplant
If the corneal injury is very severe or very extensive, surgery is the only effective solution. In parallel, “for a couple of decades now, we have also transplanted stem cells from the cornea to solve the problems of people with certain types of changes in the ocular surface,” explains Dr. Gris. As for the source, stem cells can be obtained from a donor or from the patient's other eye (if he is healthy) by growing them in a laboratory for subsequent transplantation.
We also perform corneal stem cell transplants to address the problems of people with certain types of ocular surface diseases.
Dr. Óscar Gris
Individual techniques depending on the patient’s state
“At the IMO Miranza group, we apply a very personalized approach to medical and surgical interventions. We aim to resolve the patients vision problems, according to each individual case, depending on the speed of the disease evolution and the particularities of the affected area of the cornea,” the expert says. He adds: "We are the pioneers in corneal transplantation: Between my colleague Dr. Jose L. Güell and myself we perform over 200 transplants per year in Barcelona.”
In 90% of cases, the transplanted tissue is viable. This makes us proud especially because it means that we are helping to improve the vision and therefore the quality of life of the patients who visit us.
Dr. Óscar Gris
New advances in the treatment of corneal injuries
In addition to their day-to-day work in the diagnosis and treatment of eye diseases, the ophthalmologists of the IMO Miranza Group also contribute to the advancement of ophthalmology and lead im portant international research projects. In this direction, the IMO Foundation is developing a promising research project focused on diseases affecting the endothelium, many of which are considered a rarity. One of the best known is a minority degenerative disease that usually affects both eyes and causes severe visual impairment: Fuchs endothelial dystrophy.
According to the project's principal investigator, Dr. José L. Güell, “Most patients with these conditions ultimately require a complete corneal transplant. This project aims to demonstrate if, in these cases, removing only the corneal endothelium can be an effective treatment, ”Guell adds.
On the other hand, Dr. Oscar Gris was the national coordinator for another project. The European Multicenter, also developed by the IMO Foundation, is aimed at patients who have suffered corneal injury due to eye burns (causticization). In this case, “we extract a small portion of stem cells from the epithelium of a healthy intact eye and culture to increase their number, and then transplant them into the damaged part of the eye,” concludes Gris.
These research studies aim to help find new treatments that are individualized for patients and thus improve their quality of life and vision.