Non-surgical contact lens therapy available

Posted: Tuesday, January 04, 2005

JACKSONVILLE, Fla. - Nearly 20 years ago, Jim Doherty suffered a severe head injury, leaving him blind in his left eye.

Every year since the injury, Doherty said his eye would form an ulcer requiring the 72-year-old to medicate it and wear a patch for at least four days. The yearly process was exhausting, he said, bringing him to the point of wanting the eye replaced with a glass one.

He was referred to a Jacksonville eye specialist, who performed a new procedure that healed his eye without surgery and eliminated the need for eye replacement.

Arun Gulani, medical director of Gulani Vision Institute, incorporated amniotic membrane made from human placenta into the form of a contact lens and placed it onto Doherty's eye to promote healing. Before, the membrane would have been surgically stitched in place during a lengthy surgery and hospital stay.

Although amniotic membrane has been used in procedures for a few years, Doherty was one of the first patients in Florida and among the first in the world to use it as a non-surgical contact lens, Gulani said. The membrane - similar to cellophane paper - acts like a natural bandage and regenerates the eye's surface during surgeries and reconstruction. It is approved by the Food and Drug Administration, he said.

"A three-hour surgery is reduced to 30 seconds," Gulani said about the new lens procedure. "This is raising the bar in eye surgery to allow patients the best possible care."

Gulani said the lens now allows other procedures to be performed on patients, enabling him to further remove scar tissue and repair damage without invasive surgery. Medicare and most major insurance companies cover the procedure, he said.

Amit Chokshi, director of corneal and refractive surgery at Shands Jacksonville Medical Center, said while the advantages of no surgery and stitches are beneficial, there are potential downsides to the contact lens. He said in order for the amniotic membrane to be effective, it must stay in a patient's eye for a few weeks.

There's a risk the lens could fall out without the patient's knowledge, he said, and replacement lenses could be expensive. He also said studies haven't been done showing whether the lens is more or less effective than stitching the membrane onto the eye.

"The amniotic membrane has only been around for less than seven or eight years - not completely new, but new enough that there are no studies yet," Chokshi said. "The idea of convenience is definitely a valid one, but long-term studies haven't proven anything yet."

Jacksonville patient David Hull, 43, underwent one procedure after an alkaline burn caused severe damage to his left eye. After two months of eye drops to help heal his injury, he was told he needed a corneal transplant in order to restore full vision. Uncomfortable with the idea of surgery, he searched for a second opinion.

Gulani initially used the placenta contact lens to help heal scars from Hull's eye's surface. After the eye was healed, Gulani removed scar tissue from the cornea and corrected the vision using an advanced form of Lasik called advanced surface ablation. It was a three-minute procedure that eliminated the need for a corneal transplant, Gulani said.

"It just blew me away when he explained what he could do for me," Hull said after the placenta procedure. "I could have had a complete corneal transplant and there was no guarantee [it would be a success]."

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