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Cornea Clinical Update – EyeNet August 2018

EK Evolves: Are PDEK and Hybrid DMEK on the Horizon? 

Advances in endothelial keratoplasty are giving patients with corneal endothelial dysfunction ever-more novel treatment options even though Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) are the mainstays. “The field of endothelial keratoplasty is a dynamic one; it has been revolutionized in the last 20 years, and we are continuing to refine our surgical approaches,” said Kathryn A. Colby, MD, PhD, at the University of Chicago.

Eye Banks’ Key Role

Dr. Carlson, however, has worked out a solution to the eye bank issue. In North Carolina. About 3 years ago, Ashiyana Nariani, MD, MPH, Dr. Carlson’s fellow, introduced him to PDEK, which she had learned from Dr. Agarwal. Drs. Carlson and Nariani worked closely with Miracles in Sight Eye Bank in Winston-Salem, North Carolina, to determine how the eye bank could prepare PDEK grafts effectively and predictably in order to minimize waste of corneal donor tissue and endothelial cell loss. The result, said Dr. Carlson, is that “Miracles in Sight Eye Bank has done a tremendous job preparing tissue that is preloaded and prestamped.”

Read the entire article from the August 2018 publication of EyeNet.

EyeNet Magazine 

Duke Eye Center – Immune Response Likely Culprit in Eyelid Gland Condition That Causes Dry Eye

Duke Eye Center's Saban Dry Eye Study Illustration

Immune cells that normally rush in to protect the eyes from infection might actually be disrupting moisturizing glands and causing dry eye, a disease that afflicts more than 30 million people in the United States.

This finding from a research team led by Duke Eye Center could lead to more effective therapies for dry eyes instead of treatments that only address symptoms. 

“This study shows that some forms of Meibomian gland dysfunction (MGD) are inflammatory diseases, and our studies in mice confirm what we see in the tears of people with blocked glands,” said Duke ophthalmologist Preeya K. Gupta, M.D., a co-author of the study published July 25 in the journal Science Translational Medicine. “This pathway may be a new target for therapeutic agents to help treat patients suffering from dry eye disease and MGD.”

Read the entire press release via Duke Eye Center. 

Miracles In Sight Seeks to Expand Adoption of Innovative Surgery with Prepared DMEK Grafts

WINSTON-SALEM, N.C. – Across the world, Descemet Membrane Endothelial Keratoplasty (DMEK) is becoming the standard of care for endothelial dysfunction. Miracles In Sight (MIS), a nonprofit eye bank that recovers, processes and distributes ocular tissue, is helping reduce the learning curve for this new surgical technique by offering traditional, pre-loaded and free-floating DMEK grafts.

“Corneal surgeons are increasingly finding DMEK to be the best option for their patients, however, the possibility of tearing the thin, delicate tissue can be stressful for surgeons preparing donor tissue themselves,” said MIS Director of Research and Development Isaac Perry. “The pre-loaded and free-floating DMEK grafts from MIS eliminates this step.”

The DMEK surgical procedure involves transplanting donor Descemet membrane and endothelial cells into a recipient with a damaged or diseased corneal endothelium. The surgery takes less than 30 minutes and has demonstrated the ability to restore sight in legally blind patients. Surgeon partners collaborating with MIS for nearly a year have experienced positive outcomes using pre-loaded and free-floating DMEK tissue, reporting that it saves time in the operating room.

“I have been performing DMEK for several years and one of the more challenging steps in this procedure is donor tissue preparation,” said Terry Semchyshyn, M.D., director of the Duke Eye Center for Vision and Correction in Winston-Salem, N.C. “The tissue handled as well as it did with my own surgeon-cut tissue, and I am pleased I made the switch. I encourage any surgeon currently performing DMEK to consider trying pre-loaded tissue.”

MIS offers customizations for DMEK tissue to meet a surgeon’s requirements. DMEK tissue can be pre-punched to specific diameters, marked with “S” stamps to aid in graft orientation or pre-loaded into a modified Jones Tube for injection.

“Pre-loaded DMEK from Miracles In Sight saves me 10 minutes per case and relieves the stress of tearing tissue during preparation,” says David Tremblay, M.D., of the Mann Eye Institute in Austin, Texas. “The tissue is pre-stained and marked with an ‘S’ stamp and simply needs to be attached to a syringe and injected into the eye. The experienced technicians at MIS are highly skilled with DMEK preparation. I couldn’t imagine going back to preparing tissue myself.”

MIS strives to be at the forefront of ophthalmological care and continually seeks new and innovative techniques to fight corneal blindness as they are developed and perfected.

“We want to help expand the use of this innovative surgical technique,” added Perry. “Prepared DMEK grafts simplify the procedure and offering this service is a logical extension of our organization’s mission to aid surgeons in restoring sight.”

About Miracles In Sight

Miracles In Sight (formerly the North Carolina Eye Bank), based in Winston-Salem, N.C., USA is one of the largest eye banks in the world. The mission of Miracles In Sight is to support the restoration, preservation, and enhancement of sight through transplant, research, education and innovation. A significant part of this mission is stewardship focused on training and educating the medical community and supporting partners and organizations around the world. For more information, visit www.miraclesinsight.org.

Miracles In Sight Contributes Corneal Tissue to Help Train Surgeons in Vietnam

(WINSTON-SALEM, N.C.) — Miracles In Sight (MIS), a nonprofit eye bank that recovers, processes and distributes ocular tissue, recently supported an effort led by UNC Eye to train ophthalmologists in Vietnam. MIS provided all the corneal tissues for the trip, resulting in 16 Vietnamese patients receiving the gift of sight.

“The surgeons at the Vietnam National Institute of Ophthalmology (VNIO) were very appreciative of the donation,” said UNC Eye M.D. Kenneth Cohen who organized the trip.

Miracles In Sight Contributes Corneal Tissue to Help Train Surgeons in Vietnam
Miracles In Sight provided corneal tissues to support a training mission led by UNC Eye MD Kenneth Cohen with surgeons from the Vietnam National Institute of Ophthalmology in Hanoi. The donation by MIS resulted in 16 Vietnamese patients receiving the gift of sight.

Training with VNIO surgeons in Hanoi took place in March and focused on corneal transplant and cataract surgeries. UNC Eye Residents Kyle Huynh, M.D. and Lee Moore, M.D. traveled with Dr. Cohen to Vietnam to support the effort.

“They had 26 patients for us to see. We graded each patients’ severity and did the surgeries over a three-day period,” said Huynh. “All of the patients did very well and had good outcomes.”

Huynh, a senior resident, says access to corneal tissue in Vietnam is a challenge for the well-trained surgeons at VNIO. “It’s a cultural issue. Buddhists do not have a strong donation or transplant platform,” he said. “We could not have done it without the support from Miracles In Sight. The surgeons were extremely grateful.”

MIS provided all the corneal tissues for the trip including DSEK tissues and full-thickness PKP grafts. The donation was a natural extension of the eye bank’s mission to restore sight.

“It is a rewarding experience to be involved in making someone’s life better,” said Dee Hatcher who manages client education and marketing for MIS. She managed logistics and coordinated with various vendors to ensure all tissues, devices and equipment arrived in Vietnam. 

For Huynh who was born in Bien Hoa, Vietnam and came to the United States at age four, the trip offered him the unique opportunity to practice ophthalmology in another country and experience the culture.

“I learned a lot as a resident. I was able to participate in surgeries with attending surgeons and other residents. Our professional relationships as ophthalmologists transcended any cultural differences,” he said. “Dr. Cohen is valued for his expertise and there is a desire to continue to build upon the training. They want us to come back to teach DMEK.”

About Miracles In Sight

Miracles In Sight (formerly the North Carolina Eye Bank), based in Winston-Salem, N.C., USA is one of the largest eye banks in the world. The mission of Miracles In Sight is to support the restoration, preservation, and enhancement of sight through transplant, research, education and innovation. A significant part of this mission is stewardship focused on training and educating the medical community and supporting partners and organizations around the world. For more information, visit www.miraclesinsight.org.

Miracles In Sight Honored By IFB Solutions With 2018 Commodore Funderburk Visionary Award

Miracles In Sight President and CEO Dean Vavra is pictured with IFB Solutions Board Chair Ann Johnston

(WINSTON-SALEM, N.C.) — Miracles In Sight (MIS), a nonprofit eye bank that recovers, processes and distributes ocular tissue, was honored for its continued partnership and support of IFB Solutions’  mission with the 2018 Commodore Funderburk Visionary Award. For many years, Miracles In Sight has been a strong supporter of IFB’s community outreach initiatives.

Miracles In Sight President and CEO Dean Vavra is pictured with IFB Solutions Board Chair Ann Johnston

Miracles In Sight President and CEO Dean Vavra accepted the award. Vavra has served on IFB’s board of directors since 2013 and was instrumental in connecting MIS with IFB to advance both organizations’ missions.

“Dean recognized the synergies between our two organizations and Miracles In Sight has been a generous supporter in helping us fulfill our mission of providing opportunities to people who are blind and visually impaired,” said IFB Solutions President and CEO David Horton. “We are incredibly appreciative of their partnership and support and congratulate them on this well-deserved honor.”

Miracles In Sight partnered with IFB in 2013 to create the Eye Care and Education Center and supported the launch of a mobile vision center with a nearly $1 million donation. It has advanced the mission of IFB’s SEE After School Program with the purchase of buses to transport blind or visually impaired children and teens to Tracy’s Little Red School House where they receive essential life and social skills. Miracles In Sight also partners with IFB at the Durham Community Low Vision Center.  

“We strive to make a positive impact on the lives of as many people who are living with curable blindness. It is an honor to receive this award,” said Vavra. “MIS is proud to support IFB and its programs. We look forward to continuing our partnership in the years to come.”

The Commodore Funderburk Visionary Award is named after Commodore Funderburk who joined IFB Solutions as a mattress-maker in 1963. He could not hear, see or speak. In 41 years of working at IFB, he never missed a day of work.

MIS was presented with the award during IFB Solutions annual banquet in April.

About Miracles In Sight

Miracles In Sight (formerly the North Carolina Eye Bank), based in Winston-Salem, N.C., USA is one of the largest eye banks in the world. The mission of Miracles In Sight is to support the restoration, preservation, and enhancement of sight through transplant, research, education and innovation. A significant part of this mission is stewardship focused on training and educating the medical community and supporting partners and organizations around the world. For more information, visit www.miraclesinsight.org.

About IFB Solutions

IFB Solutions is a nonprofit corporation that provides employment, training and services for people who are blind or visually impaired. In 2000, IFB began producing eyeglasses for the Department of Veterans Affairs, a customer partnership that remains today with IFB supplying eyeglasses to nearly 40 VA locations in the United States. As the largest employer of people who are blind or visually impaired in the United States, IFB operates the optical lab and a large-scale manufacturing facility in Winston-Salem, N.C., along with manufacturing facilities in Asheville, N.C., and Little Rock, Ark. Through its operations and community support, IFB Solutions funds programs for adults and children who are blind or visually impaired. For more information, visit http://www.ifbsolutions.org/.

Restoring Vision Worldwide

Restoring Vision Worldwide

Miracles In Sight Aims To End Corneal Blindness

BY ISAAC L. PERRY, BS, MBA, CEBT

At Miracles In Sight, a nonprofit eye bank that recovers, processes, and distributes ocular tissue, our goal is to bring vision and hope to the world. We recover tissue from about 6,000 eyes each year, about 70% of which are transplanted. The tissue that doesn’t meet quality standards is used for surgical training or research at academic institutions. Our tissue preparation services cover all types of cornea surgery. What’s more, because the supply of corneal tissue in the United States exceeds demand, we distribute tissue internationally and continually find new ways to help the blind.

Future innovations revolve around the three core components of health care’s so-called iron triangle: cost, quality, and access. As we continue to develop our service offerings around these ideals, several fertile areas for innovation have emerged.

Making Key Connections

Miracles In Sight responds to notifications by the central organ procurement organization that someone has died and may be a candidate for donation. We discuss this option with families during a very difficult time in their lives, just hours after they have lost a loved one. Often, the death is unexpected and the donor may be relatively young. Ultimately, we want to gain consent and move forward with recovery, but we know firsthand that the decision to donate — while every generous and profound — is also extremely difficult, especially when it’s made at such a painful time.

Our goal as an organization is to continually strengthen our bonds with donors and families, recognizing their enormous generosity and, ultimately, helping them derive some meaning from a devastating loss. We let families know that thanks to their generosity, a blind person may regain his or her vision in a few days. Donor families are sent a thank you letter and a blanket as a token of appreciation.

Through community outreach, we strive to educate our local population about the benefits of donation with the goal of generating an open discussion. We encourage people to talk to their families about their desire to donate, so that if their family members are faced with an unexpected tragedy, they’re prepared to make the decision based on knowledge of their loved one’s wishes. This informed decision allows us to recover tissue more quickly, which can lead to better surgical outcomes.

Read the entire article in The Ophthalmic ASC’s February 2018 Edition.

OASC February 2018

Inspiration. Collaboration. Innovation.