Casey Eye Institute - Patient Services

Corneal Research at Casey Eye Institute

Lamellar Keratoplasty

In the Cornea Division at Casey Eye Institute, our doctors have had a long-standing interest in lamellar keroplasty, or partial thickness corneal transplants. To date, these studies have yielded remarkable results. Corneal transplants most often involve replacing the entire cornea with the cornea of a donor. The difficulty in these traditional corneal transplants is often in accurately matching donor and recipient tissues. Sometimes, however, a person’s entire cornea does not need replacement. Our doctors are researching methods to improve partial cornea transplants with the help of a cryolathe, which processes donor tissue prior to transplantation. This procedure provides faster post-surgery recovery, greater vision stability and better visual outcomes.

Cornea Stem Cell Transplants
Doctors at CEI are also researching cornea stem cell transplants in which peripheral cornea cells are used to replace normal corneal cells that have been damaged by either chemical burns or disease. Donor cells are most effective when they originate from the patient or a relative. These efforts also include the study of wound healing factors to accelerate healing in the cornea and identifying agents that inhibit healing such as drugs, preservatives and sunlight.

Dry Eye
Several ongoing studies exploring tearfilm production in dry eye patients are currently underway at CEI. These studies include a variety of different approaches to relieving dry eye discomfort and its associated symptoms. One study, for example, includes examining the effects of androgen, a kind of testosterone, on tearfilm production. Another study is exploring the use of blood serum to treat corneal ulcers and dry eye.

Acanthamoeba
Doctors at CEI are on the forefront of researching acanthamoeba, a recently discovered and relatively rare parasitic infection in the cornea. This condition can cause chronic irritation and redness in the infected eye, in addition to an eventual reduction in vision. Acanthamoeba is detectable through the use of a confocal microscope, an instrument that utilizes light to view cornea cells under very high magnification. Casey Eye Institute is the only center on the West Coast with a confocal microscope.

We are developing new methods to test antibiotics that are active against this devastating problem. Such tests are currently unavailable anywhere. We hope to provide clinicians with a resource to test infections and to determine the best treatments. We also are developing tests to determine the virulence of different strains of acanthamoeba, which vary greatly. Again, such tests are currently unavailable anywhere. Improved detection of acanthamoeba is also being pursued with advances using DNA detection methods.

Confocal Inflammation
We are using the Confocal Microscope to investigate the fundamental processes such as that which occurs in conjunctivitis and Scleritis. The work is being done in collaboration with the uveitis service and Dr. James Rosenbaum. We hope insight and understanding will bring new and better therapies for these conditions.

Corneal Dystrophies
We are investigating the genes that are the basis for several of the most important inherited disorders of the cornea. These diseases are the reason behind most corneal transplants. If we can identify the genes and how they work, we may be able to devise therapies to treat them rather than resorting to surgical replacement.

Refractive Surgery Research at Casey Vision Correction Center

Comparing Corneal Flap Thickness
Through confocal microscopy, doctors at CVCC are comparing and evaluating the consistency of flap thickness in post-operative refractive surgery patients treated with a variety of microkeratomes. Microkeratomes are the instruments used to create the flap in the cornea prior to applying laser energy during LASIK. The confocal microscope provides unique insight into the condition of various layers of corneal tissue following refractive surgery, especially LASIK.

Dry Eye in Refractive Surgery Patients
Our doctors are also working to evaluate the impact of LASIK and PRK procedures on tearfilm production and function, especially in those patients presenting dry eye symptoms after refractive surgery.

Effects of Drugs on Eyes
In one of the few research projects of its kind nationally, doctors at CVCC are researching side effects of various drugs on eyes. In particular, doctors have been exploring the effect of dilating eye drops used during the LASIK procedure. Doctors also recently submitted a paper entitled “LASIK Complications in Diabetes Mellitus,” the first paper to explore the effects of refractive surgery on the diabetic population.

Continued FDA Studies
Over the past seven years, Casey Vision Correction Center has played a key role in gathering and reporting data as part of the FDA studies used to introduce and develop the Nidek EC-5000 Excimer laser system. Today, our doctors continue to contribute to FDA studies for the EC-5000 Excimer laser and perform follow-up reporting for the eleven FDA studies that CVCC has participated in to date.