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Last Updated: Tuesday, 13 June 2006, 09:22 GMT 10:22 UK
Pioneering eye operation in baby
Cornea implant
The plastic implant is fitted into the cornea
US doctors have successfully carried out the first artificial cornea implant operation on a British child.

Seven-week-old Aaron Rai from Windsor had the operation after his father found one of only two doctors in the world who do the procedure in babies.

Professor James Aquavella, who carried out the surgery at Rochester Eye Institute in New York, said the two-hour operation went 'very well'.

The team has done 19 such operations in children - all have been successful.

"With this prosthesis in place the quality of the vision should be good but what has to happen is the brain has to learn how to use that image."
Professor James Aquavella

Aaron was born with an Anterior Segment Development disorder in his right eye - which meant he couldn't see out of the eye because the cornea, the transparent dome of tissue that covers the eye and focuses light, was opaque.

The operation to replace his cornea with a plastic prosthesis was carried out on Monday.

Aaron's father Surinder Rai, found the US team willing to carry out the operation after British doctors decided the potential benefits of surgery did not outweigh the risks because Aaron could still see out of one eye.

Professor Aquavella told the BBC website that they found no other problem with Aaron's eye and the operation went ahead as planned.

"We are very pleased. With this prosthesis in place the quality of the vision should be good but what has to happen is the brain has to learn how to use that image."

Eye patch

Other operations by Professor Aquavella have been done in children aged four weeks to seven years - Aaron is the second youngest child to be fitted with an artificial implant.

"The ideal case is to operate before two months of age," he said and explained that if you operate early the brain can learn to process visual information properly.

"Starting over the next few days the other eye will be patched for a few hours a day - the idea is to get him to use an eye that he hasn't been using before."

He added: "It will be years before we can assess definitively whether the operation has been successful because he has to be old enough to read out letters and answer questions but there are ways we can assess the eye in the meantime, for instance we can give the child objects of different sizes to play with."

Aaron was able to leave the hospital later the same day to spend the night with his parents in the hotel.

They plan to return to the UK at the weekend.

Hoping for a breakthrough

In the UK, transplants are done using corneas from donors but usually only in children who are blind in both eyes.

Mr Ken Nischal, consultant ophthalmologist at Great Ormond Street Hospital for Children, examined Aaron before he went to the US.

He said: "We have a tremendous amount of experience in these children; we have done 63 corneal grafts in babies."

"I'm supportive of the parents choice; it was a difficult decision for them and I'm hoping this is a breakthrough but I don't have any scientific data to analyse.

"I feel apprehensive because we don't have the data. Even if I had the experience with this [type of artificial implant] I wouldn't have done it in this child.

"We don't know how long the material will last - it might not last longer than 10 years."

He added that with one good eye, Aaron would be able to lead a perfectly normal life.

Ranjit Rai, Aaron's mother, told The Times she was initially "very worried" about the operation but was won over during a trip to the US to meet Professor Aquavella.

"We were very fortunate in that we were sufficiently focused and that our perseverance paid off so that we were able to identify an alternative way forward," she said.

Appeal for more eye tissue donors
07 Apr 05 |  Southern Counties
Artificial cornea project funded
19 Aug 04 |  England

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