Tear Film Research
Dr. James Aquavella has organized a group of basic scientists including Geunyoung Yoon, Krystel Huxlin, and Jim Zavislan to evaluate human tear film dynamics and its relationship to clinical dry eye syndrome. Utilizing three new technologies developed at the Eye Institute, including wave front analysis, OCT and ellipsometry, the team is measuring variations in tear film thickness and composition related to the normal blink reflex during altered environmental conditions. This multidisciplinary approach—which may lead to a better diagnosis and treatment of clinical dry eye—is a collaborative effort between the Eye Institute and the departments of immunology, oral biology, optics, and dermatology.
A corneal transplant also known as a corneal graft or keratoplasty is a surgical procedure that replaces the scarred or diseased cornea with clear corneal tissue from a donor. One of the newest technologies in corneal transplantation is posterior lamellar kerotoplasty. The Eye Institute is one of a limited number of centers nationally that is conducting clinical trials. Steven Ching, M.D., who has conducted corneal transplant studies and pharmaceutical trials for several decades, is heading up this area of clinical research.
For the past 40 years, corneal transplantation has involved replacing the central cornea in partial thickness transplants or full thickness penetrating kerotoplasty. While highly successful, these procedures also present some problems for patients. Healing is a slow process with sutures often left in place for a year or more, raising the risk of infection and rejection. Most patients will also experience astigmatism at a rate significantly higher than people with healthy eyes.
Over time, surgeons and researchers have learned that most diseased corneas are diseased only in the back layer, paving the way to posterior lamellar kerotoplasty. In this revolutionary procedure, with just a small side incision, only the diseased back layer is replaced, about 20 percent of the cornea. Early results show that this new technology allows patients to heal faster with less risk of rejection and less astigmatism.
Like other physicians and scientists throughout the Eye Institute, these researchers are moving toward a more global view of their specialty area—leveraging distinct perspectives to preserve and enhance vision for their patients and for future generations.
Optical Quality of the Eye
The wave front sensing program studies the pre-surgery wave front aberrations in the eyes of refractive surgery patients, and how those aberrations can be minimized by the development of improved refractive surgery procedures. This project will be relocated to the Flaum Eye Institute Ground Floor within 2 years, where the physiological optics research space will be immediately adjacent to the refractive surgery clinic. This project involves Dr. David Williams of the Center for Visual Sciences and Dr's. Scott MacRae, Krystel Huxlin, Geunyoung Yoon and William Fischer of the Ophthalmology Department.
The cornea research program involves several faculty. Dr. Geunyoung Yoon and Dr. James Aquavella study the optical properties of the highly aberrated corneas of patients with corneal diseases such as keratoconus, and are developing methods to treat those disorders. Dr. Yoon is also developing methods to adapt the methods of wave front sensing (above ) to the manufacture of contact lenses that can provide customized correction of high order refractive errors. Drs. Jianhua Wang, James Zavislan, and James Aquavella are measuring the optical properties of the tear film, with the goal of developing methods for the amelioration of tear film abnormalities such as dry eye. This group uses wave front sensing, optical coherence tomography (OCT) and polarimetry to make these measurements.