Patients who are blind or whose vision is severely impaired wait for many months to obtain a biological cornea taken from a cadaver and purchased in the US or Canada or provided by pathologists at the National Center for Forensic Medicine at Abu Kabir.
Breaking ground with new biotech
But now, ophthalmologists at Jerusalem’s Shaare Zedek Medical Center (SZMC) have achieved a medical breakthrough with the first implant of the thinnest 3D cornea made from synthetic acrylic material and attached to the inside of the patient’s cornea.
The fortunate patient, whose vision in the eye with the new implant underwent the successful surgery six weeks after a long period of severely impaired vision and significant pain, is a 71-year-old Muslim Arab from Jerusalem. He previously underwent the implantation of a cornea from a cadaver, but his body rejected it about two years ago. His other eye functioned normally, but now the vision through his two eyes is very good, and he no longer suffers from considerable discomfort due to edema (swelling from fluids).
The synthetic cornea was developed and produced by EyeYon, an Israeli start-up in Ness Ziona. The company has received Health Ministry approval for the use of the implant and has applied for similar approval from the US Food and Drug Administration.
It has provided its breakthrough product to a few hospitals in Holland, India and China, but this was the first such surgery in Israel and the thinnest artificial cornea in the world.
A unique approach that speeds up recovery
EyeYon, which conducted lab research on rabbits, chose SZMC as the first Israeli hospital for using the artificial cornea, even though the Rabin Medical Center in Petah Tikva carries out some 200 cornea implants per year. The company provided SZMC with the artificial cornea for free, but in the future, it would have to be added to Israel’s basket of health services.
The surgery is performed with a unique approach that speeds up recovery – the patient was in the hospital for only a day – and achieves very accurate results that prevent rejection of the implant.
“This is another step toward a future in which the dependence on the availability of human tissue for the purpose of performing corneal transplants in patients who need it will be reduced, Dr. Liron Berkovich told The Jerusalem Post.
Berkovich, a specialist in corneal disease and corneal surgery who performed the implant together with SZMC Ophthalmology Department chairman Prof. David Zadok, joined the department 18 months after working previously at Haifa’s Rambam Medical Center and in Leicester, England.
“Instead of using a cornea from a person who has died, they will use a custom-made cornea with full availability,” he said.
Due to the fear that a human implant would be rejected again, the SZMC team decided to implant the EndoArt – a 50-micron-thick synthetic corneal implant printed at EyeYon.
The surgery is performed through an incision of about two millimeters in the wall of the eye, using advanced imaging that enables the attachment of the implant to the patient’s endothelial tissue.
The far-reaching benefits of a synthetic cornea
About half of all patients who need corneas to restore their vision could benefit from the synthetic cornea, Zadok, a specialist in corneal diseases and surgery, told the Post. As EyeYon is an Israeli company, it can provide an ongoing supply of the product so that patients will no longer have to wait for many months for transplants due to unavailability of human corneas.
Zadok’s department annually performs 60 to 70 implants of corneas from cadavers, but now about half of them who have endothelial tissue on the inside of the cornea are expected to involve the synthetic ones.
A few companies abroad, in North Carolina in the US and in South Korea, produce biological corneas with 3D printing, but these pose the risk of rejection. The acrylic cornea is not rejected by the body and will last a lifetime, according to Zadok and Berkovich.