7-month-old is youngest recipient of artificial corneal transplant

A 7-month-old child whose first corneal transplant was unsuccessful underwent surgery Monday at the University of Rochester Eye Institute to implant an artificial cornea in an effort to give him sight. He is the youngest patient ever to receive the device.

Lukas Rakowsky of Dupont, Wash., was born in May with a tumor on his left eye. The tumor was successfully removed five weeks after his birth at Madigan Army Medical Center in Ft. Lewis, Wash. Lukas also underwent corneal transplant surgery that same day, in an attempt to help him achieve sight in the eye. The day after the surgery, though, Lukas' cornea began to cloud up again, signaling the transplant had been unsuccessful.

His parents, Shana and Peter Rakowsky, were referred to surgeon James Aquavella, M.D., at the University of Rochester Eye Institute. In addition to specializing in traditional cadaveric corneal transplants, Aquavella has been implanting plastic corneal devices since the 1960s. The first procedures were long and tedious, and results were not known for many months. Patients required careful follow-up for the rest of their lives in an attempt to reduce the ever-present danger of serious complications. But there have been great improvements over the past 40 years, he says, making possible new procedures like the one performed on young Lukas.

Aquavella began last spring implanting the AlphaCor, an artificial cornea that doesn't require donor tissue. The flexible, one-piece keratoprosthesis is designed to replace scarred or diseased corneas. The device is easier to implant than older models, cutting down on surgery time. The lack of donor tissue means the risk of rejection is eliminated. The new implant offers significantly more possibilities for patients at no more risk than implanting a cadaveric donor cornea, Aquavella says.

For patients like Lukas who have undergone unsuccessful corneal transplants and have little or no sight, this device can provide lim

Contact: Karin Gaffney
University of Rochester Medical Center

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