Dr
Arun Gulani dreams of being able to create entirely artificial
eyes for the blind. The NRI surgeon moved closer to his dream
by performing a corneal transplant using an artificial cornea.
He is the first and only doctor to do this in Florida. In
fact, only a handful of doctors in the world are qualified to
perform this procedure, seen as a landmark in eye-surgery.
"This is the first step of my dream coming true," says Dr
Gulani, who is the director of cornea and refractive surgery
at the UF Department of Ophthalmology in Jacksonville,
Florida. This is indeed the stuff of science fiction, claim
eye experts. Dr Gulani is also a renowned expert on Lasik
laser eye surgery and the founder-director of the University
of Florida Lasik Institute.
Dr Arun Gulani
dreams of being able to create entirely artificial eyes for
the blind. The NRI surgeon moved closer to his dream by
performing a corneal transplant using an artificial cornea. He
is the first and only doctor to do this in Florida. In fact,
only a handful of doctors in the world are qualified to
perform this procedure, seen as a landmark in eye-surgery.
"This is the first step of my dream coming true," says Dr
Gulani, who is the director of cornea and refractive surgery
at the UF Department of Ophthalmology in Jacksonville,
Florida. This is indeed the stuff of science fiction, claim
eye experts. Dr Gulani is also a renowned expert on Lasik
laser eye surgery and the founder-director of the University
of Florida Lasik Institute.
The cornea is an eye's
window to the world. Until recently, about 10 per cent of all
people who needed a new cornea had no hope of regaining
vision. Some had rejected transplanted corneas. Others had
eyes so severely diseased or so scarred from accidents that a
real cornea could not adhere and survive.
Human
corneal transplants are performed quite often, Gulani said,
but until now, they were not possible using artificial
corneas. The artificial procedure is still only being used to
treat complex and high-risk cases, typically people who have
rejected several human corneal transplants. Patients who have
given up on seeing again. "These are patients looking for a
ray of hope," says Dr Gulani.
The Lions Eye Institute
of Western Australia makes the artificial corneas. They are
flown in whenever Gulani is scheduled to perform a surgery.
The Australian company has only selected a few doctors around
the world to perform this surgery, which has been approved by
the U.S. Food and Drug Administration.
In an exclusive
interview to Sify.com, Dr Gulani outlines the cutting-edge
procedure and its benefits.
What is artificial corneal
transplant surgery? How does it help patients with damaged
corneas?
Artificial Corneal Transplant surgery is a
landmark event in the field of ophthalmology. It involves a
specially designed material that has the ability to get
incorporated into the human eye as well as maintain clarity
for vision. The surgery is a two-staged delicate procedure
which involves inserting this special device into the
patient's own damaged cornea (window of the eye) and after
three months, it allows the patient to see out of it.
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 laser very similar to the one I use
for Lasik surgery to enable these patients to achieve their
best corrected vision.
Since most of these patients
have had multiple surgeries and other associated diseases of
the eye, the visual result is dependent on that individual eye
with its co-existent pathology.
Any post operation
complications? Do the patients get their original vision back
after the surgery?
Complications are very much the
same as in any corneal transplant surgery in addition to those
of the material itself. The surgery itself requires experience
in delicate tissue handling and dissection and has made
surgeon selection an important criteria.
What are the
other radical surgery procedures that you perform?
I
do have a referral base from all over the country and abroad
and do see complex cases as well as complicated surgical
outcomes. In this, I utilise different kinds of corneal
transplant surgeries, anterior chamber reconstruction as well
as amniotic membrane (from human placenta) surgeries for
ocular surface disorders including pterygiums (A condition
commonly seen in India).
Cataract surgeries using high
tech surgical instrumentation and different Intra Ocular Lens
Implants to customise the outcomes to individual patients thus
taking cataract surgery to a higher level of visual outcomes.
Lasik surgery is my forte and I do offer cutting-edge
Lasik surgery in my practice. In this, I do also specialise in
surgically fixing Lasik complications using various
combinations of surgical techniques and technology.
Besides this I also manage specific conditions like
Dry eyes, Keratoconus and Astigmatism.
You are also
credited with designing and modifying instruments and surgical
techniques to make the surgery easier and quicker? Could you
tell us about your contributions here?
I am an
industry consultant for leading ophthalmic companies and have
invented a number of surgical instruments and techniques to
simplify various eye surgeries in order to make them more
acceptable to surgeons across the globe as I continue to teach
these new innovations in ophthalmology.
These
surgeries range from Lasik to complex corneal surgeries
including the recent Artificial Corneal Transplants.
Towards this endeavor, I have launched our company-
INNOVISION Medical- which provides my innovative ideas towards
new and emerging technology in the field of eye care.
Is artificial corneal transplant surgery available in
India? Will more doctors and hospitals be able to offer this
technique soon?
I don't believe it is presently
available in India but do not see any reason why it should not
be since I sincerely believe that India has some of the most
talented eye surgeons in the world.
As we continue to
teach and spread this knowledge based on our experience I am
sure this surgery will be accepted by many surgeons throughout
the world.
A number of eye surgeons have been visiting
with me and learning this surgery and at the recently
concluded American Academy of Ophthalmology meeting in
California, I shared my new instrumentation and surgical
technique which makes this procedure more acceptable and less
technically difficult to perform, thus eventually appealing to
all eye surgeons.
Lasik surgery seems to have caught
on in India? How does it help patients with poor eye sight?
Lasik surgery as I see it is one of the most
predictable refractive surgeries we have had in a long time.
Having performed nearly all kinds of refractive
surgeries (surgery to remove eye glasses), I offer Lasik as
one of the many surgical options to patients with various
kinds of eye glasses to best suit their needs.
Lasik
does not exactly affect poor eyesight. It basically provides
the best corrected vision that one would have with their
glasses or contact lenses. Any associated eye disease
responsible for poor sight is unaffected.
India has a
large population of patients who are near sighted and far
sighted and therefore there is an obvious demand for such a
procedure. I have a number of patients who come to me from
India and thereby am abreast with the demands and current
trends that affect the country.
Do you think that all
these medical breakthroughs will benefit the poor? Will you be
performing this transplant in India?
Absolutely. All
technological and scientific advance finally benefits mankind
in general and then of course the poor and deserving .
Yes, I do travel to India often to teach and perform
special surgeries as well as accept select consults from eye
surgeons and patients there alike and will look forward to
providing this service as well as sharing my concepts with
colleagues so they can then proceed to offer this within the
country.
Could you tell us where you are from in
India? Is anyone in India qualified to perform corneal
transplants using artificial corneas?
I am originally
from Mumbai, India and trained at Seth G.S. Medical College
and K.E.M. hospital. I am not sure at this present moment
whether anyone in India is qualified to perform artificial
corneal transplants, but as I mentioned before I don't see why
not.
Your dream is of one day being able to create
entirely artificial eyes. When will this dream come true?
Every dream according to me is a timeless goal, which
serves to propel our dedicated endeavors in a focused
direction. An artificial eye is a fantasy for every eye
surgeon since the very working of this elegant computer (our
eyes) has mesmerized mankind since centuries. An artificial
cornea is just the beginning.
I have received numerous
offers to collaborate with various centers and hospitals in
India and am seriously looking into it presently to fulfill my
desire to lead a center of excellence in India.
I am
happy to announce that the coming new year shall coincide with
the inauguration of the Gulani Vision Institute, here in
Florida. This institute will aspire to provide world-class eye
care, education and cutting edge innovation as a direct result
of a dream.
Dr.Gulani can be contacted at
arungulani@aol.com
http://sify.com/news/scienceandmedicine/fullstory.php?id=13348966
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Wednesday, 31 December , 2003, 10:24
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