A 91-year-old man who became the first patient in England to have his sight saved by an artificial layer in his cornea has praised the procedure which still allows him to see his wife.
Cecil Farley, from Chobham in Surrey, had problems with his right eye for about fifteen years before losing his sight. He needed a cornea transplant to save his sight, but his previous operation – a human cornea transplant – failed and doctors warned the next operation could do the same. And the shortage of human corneas from deceased donors forced Farley to wait a year.
But an NHS first allowed him to bypass the queue: the implantation of an artificial cornea. While it’s still too early for such implants, experts say the approach could eventually become a standard treatment and reduce the health care system’s record waiting list.
“I can still see my wife after 63 years of marriage, we can just carry on as normal and live life as fully as possible,” Farley said. “It makes your life fuller when your eyes are working properly – you don’t realize how debilitating it is until it happens to you.”
He said he would eventually like to perform tasks such as repairing a watch, but for now he was content to “move around” with his wife, Elizabeth, 83.
The device, called EndoArt, is made by EyeYon Medical and is the first artificial implant that can replace the inner lining of the cornea – the clear outer layer at the front of the eyeball. This lining plays an important role in regulating the hydration of the cornea. If it is damaged, either through injury or disease, it can lead to blurred vision and other problems.
EndoArt is similar to a contact lens: it is a domed, foldable, transparent and clear implant that carries the lens company says is made of a material designed to stick to the back of the cornea. Once placed in the eye, it can be maneuvered into place with an air bubble and secured in place with a single stitch.
Farley underwent the surgery, known as an endothelial keratoplasty, in February, making him one of only 200 recipients of the artificial implant worldwide so far.
Thomas Poole, a consultant ophthalmologist at Frimley Health NHS Foundation Trust who performed the operation, said he and his colleague Hanbin Lee had successfully given artificial corneas to four patients in the past two months and
Initial results had shown an improvement in vision. The implant costs around £1,800, which is comparable to using a human cornea.
“As I look to the future, I think this could eventually replace human corneas for certain types of corneal transplant patients,” Poole added. “In maybe 10 to 20 years, this could become the norm where we don’t need a human cornea and we can just get one out of the box.”
Poole added that Farley was “technically a very difficult first patient.” “I was prepared for it to be quite tough, but once the graft was fully attached and started working, I thought, ‘wow, this is really working well,’” he said.
Prof. Sir Stephen Powis, national medical director of NHS England, welcomed the new approach. “The use of artificial corneal transplants is an exciting and innovative step forward in eye care, which has the potential to benefit many patients who require treatment to improve or restore their vision,” he said. “It could provide an additional treatment option for people waiting for donated transplants, and it is heartening to hear that patients like Cecil are already benefiting from its use.”
NHS Blood and Transplant says that to meet all surgical and research needs, a weekly supply of 350 eyes is required. Between April 2021 and March 2022, she received an average of 88 donations per week.
According to the NHSBT Transplant Activities Report 2020-21As of March 31, 2021, 10% of people who signed up to the Organ Donation Register had chosen not to donate their corneas – something which Kyle Bennett, assistant director for tissue and eye services at NHS Blood and Transplant, said could be due to the emotion and symbolism that people attribute to the eyes.