91-year-old is first patient in England to get an artificial cornea (2024)

A 91-year-old man who faced a year-long wait for sight-saving surgery has become the first patient in England to receive an artificial cornea.

Pensioner Cecil Farley initially had surgery for a human cornea transplant, but after it failed his surgeonoffered him the chance to skip the queue by using an artificial one.

Cornea transplants usually come from deceased donors and medics hope artificial ones could tackle plunging numbers of human donors.

Since the introduction of 'opt out' transplant rules in 2020, the number of donor ops for kidneys and other organs have increased overall, yet numbers of cornea transplants have dipped by almost 40 per cent.

Experts say the public are uniquely concerned by the thought of donating eye tissue, meaning other options for patients at risk of blindness are vital.

Cecil Farley, 91, from Chobham in Surrey initially had surgery for a human cornea transplant, but after it failed his surgeon offered him the chance to skip the queue by using an artificial one

The implant used in the pioneering procedurehas been likened to a contact lens and it is surgically attached to the eye by a single stitch and put in place with a gas bubble.

WHAT IS A CORNEA TRANSPLANT?

A cornea transplant is an operation to remove all or part of someone's cornea if it is damaged by injury or disease and replace it with donor tissue.

The cornea is a see-through layer at the front of the eye which protects the vital parts such as the iris and pupil.

The operation may also be called akeratoplasty or a corneal graft.

And it is commonly performed to help people who have a condition called keratoconus, which is when the cornea changes shape.

The procedure can be performed on an entire cornea or just on the outer layers, depending on how seriously damaged it is.

Patients can be kept awake during the surgery but given local anaesthetic in their eye, or completely sedated under general anaesthetic. The op takes about an hour to complete.

Potential complications include the body rejecting the new cornea, infection, or further vision problems.

Source: NHS

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Mr Farley, known to his friends as John, is just one of 200 people worldwide to receive the treatment and said the transplant surgery has enabled him to continue to see his 83-year-old wife Elizabeth.

Mr Farley, from Chobham in Surrey, had problems with is right eye for about 15 years.

He had no vison in his right eye and now following the operation in February his sight has been slowly improving.

'I can still see my wife after 63 years of marriage, we can just carry on as normal and live life as fully as we can,' Mr Farley said.

'It makes your life fuller when your eyes work properly — you don't realise how debilitating it is until it happens to you.'

Once his sight is fully restored he wants to do practical tasks like repairing a watch, but for now he is content 'pottering about'.

'It has made a great difference to my sight. It was very blurred and I couldn't distinguish a face. Now I can see better with it, the brighter the light the better. It's coming along slowly - they said it could take up to a year,' Mr Farley said.

The cornea is the clear outer layer at the front of the eyeball.

Damage, as a result of injury or disease, can mean it becomes less transparent or its shape can change.

This can prevent light reaching the retina at the back of the eye, resulting in poor vision.

A cornea transplant can be performed to improve sight, relieve pain and treat severe infection or damage.

Frimley HealthNHSFoundation Trust consultant ophthalmologist Thomas Pooleand his colleagues have successfully given four patients artificial corneas in the last two months and initial results have shown an improvement in vision.

Mr Farleyhad no vison in his right eye and now following the operation in February his sight has been slowly improving

One of the 'beauties' of an artificial cornea instead of a human transplant is the body isn't going to try and reject it, says Frimley Health NHS Foundation Trust consultant ophthalmologist Thomas Poole

He predicts that artificial corneas may end up replacinghuman corneas completely for certain patients.

In the next few decades there might be no need for ahuman cornea with surgeons instead just taking one 'out of the box', he says.

Speaking about Mr Farley's case, Mr Poole explains he had a failed corneal graft and his cornea, which is the clear window at the front of the eye, was cloudy and waterlogged before the operation.

'He'd had lots of previous surgeries and my concern was we could use a human cornea for him again, but that's got a high risk of failure... he was kind of getting to last hope,' Mr Poole said.

Speaking about Mr Farley's case, Mr Poole explains he had a failed corneal graft and his cornea, which is the clear window at the front of the eye, was cloudy and waterlogged before the operation

In 2022/23, the latest figures available, some 4,719 corneas were supplied to NHS Blood and Transplant Eye Banks and there were 3,529 transplants

Since Mr Farley had hisartificial cornea put it in February, Mr Poole said he can already see his cornea is much less swollen than before.

'It is improving in shape, and improving in clarity. Week by week he has been saying it is getting a little bit better each time,' Mr Poole said.

He added: 'I had a very frank discussion with him before and I said 'Look, your graft has failed, you're back on the waiting list. Because your other eye sees quite well, you're not a high priority on the waiting list and you could be waiting for another year'.

'He's in his 90s now and said 'I just can't wait that long. Is there anything else?' And so this sprung to mind, I had just read a publication on very good reports from this artificial graft and it was that that made me think actually, maybe we could use this for John.'

NHS England national medical director Professor Sir Stephen Powis said: 'The use of artificial cornea transplants is an exciting and innovative step forward in eye care, which has the potential to benefit many patients needing treatment to improve or restore their vision.

'It could provide an additional treatment option for those waiting for donated transplants, and it's heart-warming to hear of patients like Cecil already benefiting from its use.'

Mr Poole and his colleague, Hanbin Lee, have successfully given four patients artificial corneas in the last two months and initial results have shown an improvement in vision including for Mr Farley

In the next few decades there might be no need for a human cornea with surgeons instead just taking one 'out of the box', Mr Pools says

In 2022/23, the latest figures available, some 4,719 corneas were supplied to NHS Blood and Transplant Eye Banks and there were 3,529 transplants, which is a drop of almost 40 per cent since 2020.

In the past some potential organ donors have said they were willing to donate organs including hearts, livers and kidneys but chose not to donate their corneas.

Kyle Bennett, assistant director for tissue and eye services at NHS Blood and Transplant, said: 'We understand that people often attribute more emotion and symbolism to the eyes compared to other parts of the body so can be reluctant to agree to cornea donation.

'However, agreeing to this form of donation, even when solid organ donation may not be possible, means there can be light after darkness for the thousands of people who require corneal transplants.

'One donor alone can help up to 10 people to restore or improve their vision and allow them to see their friends and family properly again.

Since Mr Farley had his artificial cornea put it in February, Mr Poole said he can already see his cornea is much less swollen than before

The new artificial cornea, called EndoArt, was created by ophthalmological medical device company EyeYon Medical

'We are so grateful to all those who agreed to donate their corneas after their death and restored or improved the sight of 3,259 people last year through corneal transplants.'

The new artificial cornea, called EndoArt, was created by ophthalmological medical device company EyeYon Medical.

Only 200 have been implanted worldwide to date, including in Mr Farley.

'EndoArt is the first artificial endothelial layer, a promising treatment for select eyes with chronic corneal oedema,' said the company's chief commercial officer, Charles Holmes.

'EndoArt represents a new hope to patients who are suffering from chronic corneal oedema as an alternative to human tissue.'

91-year-old is first patient in England to get an artificial cornea (2024)

FAQs

91-year-old is first patient in England to get an artificial cornea? ›

A 91-year-old man has made history by becoming the first NHS patient in England to receive an artificial cornea. Cecil Farley faced a year-long wait for sight-saving surgery after a human cornea transplant failed, but his surgeon offered him the chance to skip the queue by using an artificial one.

What is the success rate of artificial cornea? ›

All of the corneas come from eye banks in the United States, which are regulated by the FDA. The success rate of corneal transplants is amazingly good, nearly 95%.

How long does an artificial cornea last? ›

investigated over one thousand penetrating keratoplasties performed over 20 years and found that corneal grafts remained in only 55.4% of patients at 10 years, 52% at 15 years and 44% at 20 years post-surgery (12).

Do artificial corneas work? ›

“One of the advantages of an artificial cornea is that it can help restore vision in patients who are not good candidates for a living corneal transplant from a human donor,” said Dr.

How much does an artificial cornea transplant cost? ›

How much does a corneal transplant cost in India? The average cost for a corneal transplant varies from approximately Rs. 50,000 to Rs. 1,50,000 per eye, based on the type of procedure and whether associated with the laser.

What is the waiting time for a corneal transplant in the UK? ›

However, there is still an urgent need for more people to donate their corneas as currently around 6,000 patients wait for corneal transplants with an average wait time of around 18 months.

What is the life expectancy of a corneal transplant? ›

Ksenia Stafeeva, a corneal transplant can last 10 years or more without complications. However, it is still important to have regular check-ups to ensure your vision and eye health remain in good condition. In some cases, patients are able to enjoy the results of their corneal transplant as long as 20 years or longer.

Which country has the best cornea transplant? ›

Thailand. Thailand's healthcare system is renowned for its affordability and quality. Many international patients opt for corneal transplant surgery in Thailand due to its skilled surgeons and well-equipped hospitals.

What is the age limit for corneal transplant? ›

There is no standard upper or lower age limit in countries such as India, Israel, the United Kingdom, and United States, though some eye banks have historically had upper age limits of 65 years.

What is the alternative to cornea transplant? ›

A hydrophilic bandage lens, worn over the entire surface, has been effective in eliminating many ocular surface problems common to cornea transplants. This technique is effective in instances where traditional transplantation has failed or carries a poor prognosis.

What are the disadvantages of corneal transplant? ›

What are the risks of corneal transplantation?
  • Bleeding in the eye.
  • Cataracts.
  • Detachment of the new cornea.
  • Eye inflammation.
  • Refractive errors requiring glasses or contact lenses.
  • New onset or worsening of glaucoma.
  • Infection inside the eye (endophthalmitis)
  • Infections on the surface of the eye (corneal ulcer)

What percentage of corneal transplants are successful? ›

In uncomplicated cases, first-time corneal transplant succeeds in 90% of patients, however, the long-term survival eventually falls to 74% at five years and further still to 62% by 10 years; these figures are comparable to the survival of heart, kidney, and liver transplants.

Does Medicare pay for a cornea transplant? ›

Covers certain doctors' services, outpatient care, medical supplies, and preventive services. covers: Bone marrow transplants. Cornea transplants.

How many people are waiting for a cornea transplant? ›

Per year, approximately 185 000 corneal transplants were performed in 116 countries, and 284 000 corneas were procured in 82 countries. With an estimated 12.7 million people waiting for a corneal transplantation, 1 in 70 of the needs are covered worldwide.

Is there a waiting list for a corneal transplant? ›

Once the donated tissue arrives at our lab, it is carefully evaluated to ensure it is safe for transplantation. Thanks to advances in tissue-preservation methods, corneas can be transplanted up to 14 days after donation. In the United States there is no waiting list for a cornea transplant.

Are you put to sleep for a corneal transplant? ›

What happens during a corneal transplant? You may get general anesthesia to put you to sleep during the transplant surgery, or you may be awake.

How painful is a corneal transplant? ›

On the day of your cornea transplant, you'll be given a medicine to help you feel calm or less anxious or a medicine that numbs your eye. Either way, you shouldn't feel pain. Surgery is done on one eye at a time. The amount of time spent in surgery depends on your situation.

Is there a shortage of corneas in the UK? ›

Cornea donation

There is a shortage of donated corneas in the UK. Many more people would benefit from sight-saving surgery if more corneas were donated. You can also call 0300 123 2323 if you wish to join the Organ Donor Register.

What is the failure rate of a cornea transplant? ›

The incidence of graft rejection depends on the presence of risk characteristics, e.g. corneal neovascularization. In 'high-risk' corneal transplant recipients up to 70% fail within 10 years despite local or systemic immunosuppressive therapy.

How expensive is a corneal transplant? ›

Corneal Transplant Cost

According to the Agency for Healthcare Research and Quality, a corneal transplant for an advanced condition typically costs around $13,000 for an outpatient procedure or $28,000 for an in-hospital procedure for individuals without health insurance.

Will I still need glasses after cornea transplant? ›

This largely depends on the specific procedure used. In some cases, your vision may fluctuate between being better or worse before it settles down. It's likely you'll need corrective lenses (either glasses or contact lenses), even after your vision returns.

What percentage of corneal transplants fail? ›

The incidence of graft rejection depends on the presence of risk characteristics, e.g. corneal neovascularization. In 'high-risk' corneal transplant recipients up to 70% fail within 10 years despite local or systemic immunosuppressive therapy.

How successful are cornea transplants? ›

As with all types of surgery, there is a risk of complications resulting from a cornea transplant. These can include the new cornea being rejected by the body, infection and further vision problems. Most cornea transplants are successful and will work without complications for at least 10 years.

How many people get cornea transplants? ›

You may need a cornea transplant if you have any damage to your cornea, either from an illness or injury, that impairs your ability to see. 46,000 people every year have cornea transplants in the United States, making it the most common type of transplant surgery.

What is the new type of artificial cornea? ›

When a natural cornea transplant is not a good option more and more surgeons are recommending the keratoprosthesis to restore vision.

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