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Monday, 14 August, 2000, 13:35 GMT 14:35 UK
Pioneering eye surgery for babies
Ken Nischal
Mr Ken Nischal learnt the technique in Canada
Exclusive by BBC News Online's Ray Dunne

Doctors at Great Ormond Street Hospital have developed a technique which greatly boosts a baby's chances of having a successful eye transplant.

Doctors have been traditionally reluctant to carry out cornea grafts or transplants on babies who have been born with severe eye problems.

This is because they are unable to see into the baby's eyes and run the risk of causing serious damage if they operate without knowing the full extent of the problem.

But Mr Ken Nischal, an eye specialist at Great Ormond Street Hospital in London, uses high frequency ultrasound to see inside the baby's eye.

The ultrasound produces a cross-sectional picture of the cornea and the sound waves allow him to see into the first 5mm of the eye.


It allows me to decide which children will fare best from surgery

Mr Ken Nischal, Great Ormond Street Hospital

This enables him to see the exact thickness of the cornea, find the location of the lens, and identify the best approach for surgery.

The technique has been around for 10 years. It is used on adults in just four hospitals in the UK, and this is the first time it has been used on new-born babies.

The technique allows Mr Nischal to identify which babies would benefit from an eye transplant and which would not.

It greatly improves the chances of a successful operation and also reduces the risk of the graft being rejected. Babies are more likely to reject a cornea transplant than adults.

"It allows me to decide which children will fare best from surgery, whereas before we may have done 40 operations, for instance, and had 30 failures", said Mr Nischal.

"The use of the technique in trying to assess how successful the graft is going to be is extremely important and significant."

Newly-born babies

The procedure is normally carried out on newly-born babies who have been born with an opaque cornea.

Without a cornea transplant, the infants would have very poor sight or would be unable to see at all.

It must be carried out soon after birth because the brain will not learn to see well unless there is visual stimulus within the first six weeks.

If the problem is left too long, the child will have limited vision even after the cornea is replaced.

Mr Nischal learnt the technique while training in Canada and has used it to assess more than 40 children since he began working at Great Ormond Street Hospital last year.

"The technique has been around for about 10 years and I have been using it for about six years," he said.

"But what is new is using high frequency ultrasound on children."

The technique has led to successful eye transplants for 14 children.

Mr Nischal uses the technique at least once a week on newly-born children at the hospital.

See also:

13 Aug 00 | Health
Rocky wins sight fight
10 Jul 00 | Health
Lab-grown corneas 'restore sight'
05 Jun 00 | Health
Eye laser surgery 'risky'
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