From the Web Site

(This interview took place in Oct 2003)

Interview with Dr. Arun Gulani
We recently had the chance to interview Dr. Arun Gulani, one of the world's leading eye surgeons. Dr. Gulani, MD, is the Director of Cornea and Refractive surgery at the UF Department of Ophthalmology, Jacksonville in Florida, USA.

He is also a pioneer in the field of opthalmology and has developed various surgical instruments, techniques, classification systems and treatment protocols that are named after him.

He has recently performed the first Artificial corneal transplant in the entire state of Florida and is among the first in the United States of America to replace damaged corneas of patients seeking a last ray of hope towards useful vision. Surgeons and industry personnel from Australia, Chicago, California and Atlanta flew down to Jacksonville, Florida to witness this surgery.

The Australian company that makes these artificial corneas has selected only a few doctors from around the world to perform this procedure based on experience and post-operative results. Dr.Gulani was selected because of his experience with ocular surface reconstruction including full and partial corneal transplants using human donor corneas and placenta tissue.

This surgical technique has been approved by the Food and Drug Administration in the US. Hello, Dr. Gulani. Thank you for this interview.

Dr. Arun Gulani: Hello. Glad to be here. Could you tell us the details of this breakthrough in eye surgery?
AG: Sure. We performed two corneal (front layer of the eye) transplants using artificial corneas. The two-staged surgery begins with surgically removing the patient's damaged cornea and replacing it with the artificial cornea. It may take up to three months for the patient's eye to fully incorporate the artificial tissue but once this has occurred the patient is ready for the second stage. In this stage a small amount of the patient's natural tissue that has grown over the artificial cornea is removed, allowing the patient access to vision. How does the the body adapt to the artificial cornea?
AG: The artificial cornea consists of a bio-compatible, flexible material specially designed to be accepted by the patient's remaining tissue and to eventually grow together as one. What sort of patients can be helped by this technique?
AG: Artificial corneas are currently only being used to treat some of the most complex and high-risk cases, in which all other available options have been exhausted. Many of these patients have undergone numerous surgeries, have extensive corneal scarring from an accident or progressive disease, or have rejected a corneal transplant from a human donor. Is this surgery available at other hospitals?
AG: Presently the Australian company at Lions Eye Institute is being very selective.I am in the process of modifying this surgical technique and have designed new instrumentation which will make it more acceptable for widespread surgical use across the globe. I shall be sharing my work and teaching this technique to surgeons from around the world at the American Academy of Ophthalmology meeting in California this fall. So, yes I am hopeful that more doctors and hospitals are able to offer this technique soon. Do the patients get their original vision back after the surgery?
AG: Their ability to see depends on the co-existing pathology in that eye. I do envision a third stage for this surgery when after this artificial cornea is incorporated into the eye, it could be sculpted by the a very similar laser that I use for Lasik surgery to enable these patients to achieve their best vision. OK, that was very interesting. Could you tell us where you are from in India?
AG: I attended Seth G. S. Medical College (KEM) in Bombay for my MBBS and MS degrees. I am indebted to my teachers there who encouraged my constant quest for better deliverance. What other surgical techniques or procedures do you practice?
AG: I have performed almost all kinds of eye operations - and specialize in Lasik, Management of Lasik complications, Complex cataracts, all types of Corneal Transplants, Dry eye and Placental tissue surgery. While I was in India I used to conduct eye-camps to treat cataract and other problems of the eye. I do sincerely believe that India has some of the finest eye surgeons in the world. I still visit India to actively participate in teaching as well as sharing surgical skills. Having a number of patients who travel to me from India, they do have an option to see me here or in India. Do you think that all these medical breakthroughs will benefit the poor?
AG: Certainly. Eye care has progressed tremendously in the past few years. As the surgeries become more commonplace, they also become more affordable and available to more and more people. We are not there yet - for example the artificial corneas that I used in this surgery cost about US$6000 each. This is clearly too expensive for widespread use. But it is my desire find a less expensive material and make them available more widely. I have no doubt that as the technique matures and the benefits become obvious, this surgical technique will be more widely available. Thank you, Dr. Gulani. This was very informative. Our best wishes for your future innovations and success.
AG: Thank you. I enjoyed this conversation.