Jacksonville, Fla. – Imagine a day when you are rubbing your eye when your finger slips and brushes up against your eye. You feel a little pain but you never thought this simple accident would change your life forever. But it did perpetually change one Jacksonville resident’s life.
About 10 years ago, Herise Wilcox, a Westside resident, accidentally injured the cornea of her eye, which left a scar and what she thought would be a lifetime of blurred vision. For the past decade, her other eye strained to compensate for the lost vision but just could not do the job of seeing all on its own. She tried glasses and underwent two laser eye surgeries but her problems continued. She was frustrated but not ready to give up.
“My vision was very poor in my right eye,” said Wilcox. “I knew I was not seeing things that I should have been seeing.”
A few months ago she was referred to Arun Gulani, M.D., chief of cornea and external disease at the University of Florida Department of Ophthalmology in Jacksonville. He not only gave Wilcox hope of restored vision but also provided it through a unique corneal transplant only a few select surgeons in the country are performing. The procedure, called Homoplastic Lamellar Keratoplasty, involved replacing a partial layer of Wilcox’s cornea with a donated cornea that Gulani shaped to match the removed portion.
“Wilcox came to me with a disabling corneal scar, which resulted in poor vision and altered her cornea’s shape causing an irregular astigmatism,” said Gulani, who is also the director of refractive surgery at the UF LASIK Institute at Shands Jacksonville.
First, Gulani conducted an in-depth evaluation and consultation that included letting Wilcox view her own eye with a state-of-the-art Video Slitlamp Photography system. This equipment educates patients on their procedure, as well as provides a very accurate image of the depth and width of the corneal scar so the doctor can plan the lamellar replacement.
Gulani performed a delicate manual dissection of the involved cornea on both Wilcox and the donor eye in order to achieve a match and restore clarity of vision. Then he used a stitching technique, called anti-torque stitching, to hold the tissue in place while it is healing and to improve Wilcox’s irregular astigmatism created from the scar.
“I thought the surgery would be very painful but I didn’t have any pain,” states Wilcox, one of the six patients scheduled to undergo the lamellar replacement surgery that day. “He [Gulani] sat down with me and explained everything before the surgery and then talked to me throughout the surgery to make sure I was OK.”
Gulani says Lamellar replacements provide quicker recovery and decreased chance of rejection than a complete corneal transplant because the lamellar replacement leaves as much original cornea tissue as possible.
“Dr. Gulani did a very beautiful job on my eye,” said Wilcox. “I can see clearly again and my vision is better.”
Corneal scarring like Wilcox’s is not all that uncommon. Eye injuries, eye infections or complications from previous eye surgeries can all cause corneal scarring, resulting in poor vision.
When Gulani sees a patient with corneal scarring he makes every effort to not only restore clarity but to also correct any resultant abnormalities in the shape of that cornea.
“I recognize that every patient’s circumstances are unique and therefore require a procedure tailored to these particular circumstances. I want all of my patients to experience total vision correction,” he said.
In order to accomplish this, Gulani recently acquired one of the first Bausch & Lomb dual workstations in the country. This technology combines the 3-D detailed corneal topography system with the new Wavefront Analysis System to study the optical system of the entire eye. According to Gulani, Wavefront technology is the latest advance in the field of LASIK surgery.
The Wavefront device is currently only used in the U.S. as a diagnostic tool but should be approved by the Food and Drug Administration for guided surgeries in the near future, explained Gulani, who is among the few surgeons in the country already certified and experienced with Wavefront LASIK surgery.
Gulani is also an international teacher of LASIK complication management techniques and sees LASIK and other corneal complications as a referral center. For more information please call the UF LASIK Institute at Shands Jacksonville at (904) 244-9EYE.