New artificial cornea offers promise for transplant patients

A new artificial cornea may offer hope to patients who have a history of multiple human donor cornea rejections. AlphaCor, manufactured by Australian-based Argus Biomedical Pty Ltd. and marketed by CooperVision Surgical Inc., is a biocompatible, flexible, one-piece artificial cornea that has been designed to replace a scarred or diseased native cornea in patients for whom corneal graft using human donor tissue is unsuitable.

"We have been using the AlphaCor artificial cornea for about 1 year now," said corneal surgeon James Aquavella, MD. "So far, I have very good feelings about the device. We are using it in patients in whom a conventional donor graft is unlikely to be successful, or where adjunctive measures required to prevent graft rejections are medically contraindicated."

Dr. Aquavella is excited about the potential for a device like AlphaCor to provide alternatives to human corneal tissue in countries where there are low levels of tissue donation, or philosophical or religious objections to donor grafts.

How it worksImplantation of the AlphaCor artificial cornea is performed in two stages. During the first stage, a large LASIK-style flap is dissected about half way into the corneal stroma and hinged inferiorly. The flap is lifted and a 4-mm buttonhole is trephined centrally through the underlying stromal bed. The AlphaCor device is then positioned onto the stromal bed by inserting the central optical core into the newly formed corneal opening. The flap is replaced and sutured closed over the device. A segment of conjunctival flap is then sutured over the top of the entire dissection site for 3 months.

The second phase of the procedure involves using a trephine to create a 4-mm hole centrally in the corneal flap, exposing the clear optics channel of the AlphaCor below.