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Over 200 ophthalmologists from around Europe joined a surgical teaching session broadcast live from St Paul’s Eye Unit theatres recently. The guests had joined to see an advanced corneal transplant procedure being undertaken by St Paul’s Consultant Ophthalmologist, Mr Vito Romano.

The guests were a mixture of fellow Consultants and junior ophthalmologists from the University Ophthalmology Society & ESASO (European School for Advance Studies in Ophthalmology).  

The surgical procedure being demonstrated by Mr Romano was a Descemet’s Membrane Endothelial Keratoplasty (DMEK).  This delicate procedure involves transplanting the inside surface of the cornea, the clear front window of the eye, and not the entire cornea.

The thin layer of cells transplanted are a third the width of a human hair

The DMEK procedure was required because the patient, who agreed to be part of the training session, suffered a degeneration of the cells due to a condition called Fuchs Dystrophy.  This is an eye condition that affects the patient’s innermost layer of the cornea so that it becomes cloudy preventing light to travel clearly to the back of the eye causing sight impairment.

During the transplantation, a very thin layer of new cells was placed into the eye and held in place by an air bubble that supports the new layer and gradually disappears over 3 to 5 days.  The thin layer of cells are approximately one third the width of a human hair.  Unlike a full thickness corneal transplant, very few stitches are used in DMEK surgery and visual recovery is more rapid. Rejection rates are also lower after this operation, giving better outcomes for patients.

Mr Romano said, “I was delighted to welcome so many colleagues from aroundMr Vito Romano Europe into my theatre through the power of technology.  As St Paul’s is a super-regional centre of excellence, we see large numbers of patients with this condition.  This means we can fine tune our surgical skills and can share these learnt skills with colleagues.”

“As with any surgical procedure there are always risks associated, especially when considering we are transplanting a layer of the cells that are only 20 microns in thickness.  However, early indications so far are the procedure was a huge success and my thanks go to the tremendous St Paul’s theatre team that assisted and to the patient for giving their permission and allowing the learning opportunities from this procedure to be shared.  I am very grateful to them all.”

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