Submitted By: Andy Wells
Dr Arun Gulani dreams of being able to create entirely artificial eyes for the blind. The NRI surgeon moved closer to his dream by performing a corneal transplant using an artificial cornea. He is the first and only doctor to do this in Florida. In fact, only a handful of doctors in the world are qualified to perform this procedure, seen as a landmark in eye-surgery.
"This is the first step of my dream coming true," says Dr Gulani, who is the director of cornea and refractive surgery at the UF Department of Ophthalmology in Jacksonville, Florida. This is indeed the stuff of science fiction, claim eye experts. Dr Gulani is also a renowned expert on Lasik laser eye surgery and the founder-director of the University of Florida Lasik Institute.
The cornea is an eye’s window to the world. Until recently, about 10 per cent of all people who needed a new cornea had no hope of regaining vision. Some had rejected transplanted corneas. Others had eyes so severely diseased or so scarred from accidents that a real cornea could not adhere and survive.
Human corneal transplants are performed quite often, Gulani said, but until now, they were not possible using artificial corneas. The artificial procedure is still only being used to treat complex and high-risk cases, typically people who have rejected several human corneal transplants. Patients who have given up on seeing again. "These are patients looking for a ray of hope," says Dr Gulani.
The Lions Eye Institute of Western Australia makes the artificial corneas. They are flown in whenever Gulani is scheduled to perform a surgery. The Australian company has only selected a few doctors around the world to perform this surgery, which has been approved by the U.S. Food and Drug Administration.
In an exclusive interview to Sify.com, Dr Gulani outlines the cutting-edge procedure and its benefits.
What is artificial corneal transplant surgery? How does it help patients with damaged corneas?
Artificial Corneal Transplant surgery is a landmark event in the field of ophthalmology. It involves a specially designed material that has the ability to get incorporated into the human eye as well as maintain clarity for vision. The surgery is a two-staged delicate procedure which involves inserting this special device into the patient’s own damaged cornea (window of the eye) and after three months, it allows the patient to see out of it. I do envision a third stage for this surgery when after this artificial cornea is incorporated into the eye, it could be sculpted by the laser very similar to the one I use for LASIK surgery to enable these patients to achieve their best corrected vision. Since most of these patients have had multiple surgeries and other associated diseases of the eye, the visual result is dependent on that individual eye with its co-existent pathology.
Any post operation complications? Do the patients get their original vision back after the surgery?
Complications are very much the same as in any corneal transplant surgery in addition to those of the material itself. The surgery itself requires experience in delicate tissue handling and dissection and has made surgeon selection an important criteria.
What are the other radical surgery procedures that you perform?
I do have a referral base from all over the country and abroad and do see complex cases as well as complicated surgical outcomes. In this, I utilise different kinds of corneal transplant surgeries, anterior chamber reconstruction as well as amniotic membrane (from human placenta) surgeries for ocular surface disorders including pterygiums (A condition commonly seen in India).
Cataract surgeries using high tech surgical instrumentation and different Intra Ocular Lens Implants to customise the outcomes to individual patients thus taking cataract surgery to a higher level of visual outcomes.
LASIK surgery is my forte and I do offer cutting-edge LASIK surgery in my practice. In this, I do also specialise in surgically fixing LASIK complications using various combinations of surgical techniques and technology.
Besides this I also manage specific conditions like Dry eyes, Keratoconus and Astigmatism.
You are also credited with designing and modifying instruments and surgical techniques to make the surgery easier and quicker? Could you tell us about your contributions here?
I am an industry consultant for leading ophthalmic companies and have invented a number of surgical instruments and techniques to simplify various eye surgeries in order to make them more acceptable to surgeons across the globe as I continue to teach these new innovations in ophthalmology. These surgeries range from LASIK to complex corneal surgeries including the recent Artificial Corneal Transplants.
Towards this endeavor, I have launched our company- INNOVISION Medical- which provides my innovative ideas towards new and emerging technology in the field of eye care.
Is artificial corneal transplant surgery available in India? Will more doctors and hospitals be able to offer this technique soon?
I don’t believe it is presently available in India but do not see any reason why it should not be since I sincerely believe that India has some of the most talented eye surgeons in the world. As we continue to teach and spread this knowledge based on our experience I am sure this surgery will be accepted by many surgeons throughout the world. A number of eye surgeons have been visiting with me and learning this surgery and at the recently concluded American Academy of Ophthalmology meeting in California, I shared my new instrumentation and surgical technique which makes this procedure more acceptable and less technically difficult to perform, thus eventually appealing to all eye surgeons.
LASIK surgery seems to have caught on in India? How does it help patients with poor eye sight?
LASIK surgery as I see it is one of the most predictable refractive surgeries we have had in a long time. Having performed nearly all kinds of refractive surgeries (surgery to remove eye glasses), I offer Lasik as one of the many surgical options to patients with various kinds of eye glasses to best suit their needs. Lasik does not exactly affect poor eyesight. It basically provides the best corrected vision that one would have with their glasses or contact lenses. Any associated eye disease responsible for poor sight is unaffected. India has a large population of patients who are near sighted and far sighted and therefore there is an obvious demand for such a procedure. I have a number of patients who come to me from India and thereby am abreast with the demands and current trends that affect the country.
Do you think that all these medical breakthroughs will benefit the poor? Will you be performing this transplant in India?
Absolutely. All technological and scientific advance finally benefits mankind in general and then of course the poor and deserving . Yes, I do travel to India often to teach and perform special surgeries as well as accept select consults from eye surgeons and patients there alike and will look forward to providing this service as well as sharing my concepts with colleagues so they can then proceed to offer this within the country
. Could you tell us where you are from in India? Is anyone in India qualified to perform corneal transplants using artificial corneas?
I am originally from Mumbai, India and trained at Seth G.S. Medical College and K.E.M. hospital. I am not sure at this present moment whether anyone in India is qualified to perform artificial corneal transplants, but as I mentioned before I don’t see why not.
Your dream is of one day being able to create entirely artificial eyes. When will this dream come true?
Every dream according to me is a timeless goal, which serves to propel our dedicated endeavors in a focused direction. An artificial eye is a fantasy for every eye surgeon since the very working of this elegant computer (our eyes) has mesmerized mankind since centuries. An artificial cornea is just the beginning. I have received numerous offers to collaborate with various centers and hospitals in India and am seriously looking into it presently to fulfill my desire to lead a center of excellence in India.
I am happy to announce that the coming new year shall coincide with the inauguration of the Gulani Vision Institute, here in Florida. This institute will aspire to provide world-class eye care, education and cutting edge innovation as a direct result of a dream.
Dr.Gulani can be contacted at firstname.lastname@example.org