The Lens of the Eye

Medical advances make it possible to operate on the cornea, reducing the risk of rejection and fostering healing time.
Federico Bartolomei

La cornea è la prima lente dell’occhio, fondamentale nel processo di messa a fuoco delle immagini che osserviamo. Tuttavia, a causa di una malattia oculare questa funzione può essere compromessa: la cornea può perdere la sua trasparenza oppure incorrere in una modica della sua struttura e della sua curvatura, alterando, così, la vista in maniera anche severa.

Questo fenomeno può accadere in presenza di cheratocono, oppure per esiti di infezioni o traumi.

Nei casi più gravi è necessario intervenire chirurgicamente asportando la cornea e sostituendola con una da donatore.

The cornea is the first lens of the eye, essential in the process of focusing on the images we observe. However, due to an ocular disease this function may be impaired: the cornea can lose its transparency or incur a change in its structure and curvature, thus altering vision to a severe degree. This phenomenon can occur in the presence of keratoconus, or as a result of infection or trauma. In more severe cases, surgery is necessary by removing the cornea and replacing it with one from a donor. Medical advances now allow super-selective interventions that reduce the risk of rejection while also fostering healing time. To find out more, we interviewed Prof. Luigi Fontana, a great expert in corneal transplants and ocular surface diseases and, as of November 1, 2021, Professor of Diseases of the Visual Apparatus at the Alma Mater, and Director of the Complex Operative Unit of Ophthalmology at the IRCCS S. Orsola.

Corneal transplantation is the most widespread operation, in terms of the number of transplanted patients, can you give us an assessment of these first months in Bologna?

Since my arrival at S. Orsola in Bologna, we have performed around 170 cornea transplants, a huge increase compared to the past. To date, S. Orsola has become the first in the Emilia-Romagna region for the number of cornea transplants and one of the hospitals with the most transplant activity in Italy. When does a patient necessarily need a transplant surgery?

In all cases where a corneal pathology causes a significant visual reduction that cannot otherwise be improved with glasses or contact lenses.

Is corneal transplantation a safe procedure today? What is the likelihood of rejection?

The tissues we use are sourced from Eye Banks that operate through strict donor and tissue control systems that are distributed for transplantation. For these reasons, transplanted tissues are safe for the patients who receive them. The new corneal transplants are increasingly safe and reliable and have greatly reduced the likelihood of developing postoperative surgical complications.

Are there therapies that can avert or delay the risk of transplantation?

Yes, certainly. Among these, the corneal crosslink is able to halt the development of keratoconus, in many cases preventing the patient from needing a transplant. Early diagnosis of this disease and prompt treatment with crosslinks can halt the progression of keratoconus, sparing the patient the need for contact lenses or surgery to correct the keratoconus if it is diagnosed early in its onset.

Prof. Luigi Fontana

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