A 91-year-old man who became the first patient in England to have his sight saved by an artificial layer in his cornea has praised the procedure for allowing him to still see his wife.
Cecil Farley, from Chobham in Surrey, had problems with his right eye for about 15 years before losing his vision. He required a cornea transplant to save his sight but his previous surgery – a graft with a human cornea – failed and doctors warned the next might too. And the shortage of human corneas from deceased donors meant Farley faced a year-long wait.
But an NHS first allowed him to bypass the queue: the implantation of an artificial cornea. While still early days for such implants, experts say the approach could eventually become a standard treatment and help drive down the health service’s record waiting list.
“I can still see my wife after 63 years of marriage, we can just carry on as normal and live life as fully as we can,” Farley said. “It makes your life fuller when your eyes work properly – you don’t realise how debilitating it is until it happens to you.”
He said eventually he would like to tackle tasks such as repairing a watch but for now he was content “pottering about” with his wife, Elizabeth, 83.
The device, called EndoArt, was created by EyeYon Medical and is the first artificial implant that can replace the inner lining of the cornea – the clear outer layer at the front of the eyeball. This lining plays an important role in regulating the hydration of the cornea. If it is damaged, whether from injury or disease, it can result in blurred vision and other problems.
EndoArt is similar to a contact lens: it is a dome-shaped, foldable, transparent and clear implant that the company says is made of a material designed to stick to the back of the cornea. Once inserted into the eye it can be manoeuvred into position with an air bubble and secured in place with a single stitch.
Farley underwent the operation, known as an endothelial keratoplasty, in February, making him one of only 200 recipients of the artificial implant worldwide to date.
Thomas Poole, a consultant ophthalmologist at Frimley health NHS foundation trust who carried out the operation, said he and his colleague Hanbin Lee had successfully given four patients artificial corneas in the last two months and
initial results had shown an improvement in vision. The implant costs about £1,800, in the same bracket as using a human cornea.
“Looking forward to the future, I think this may end up replacing human corneas for certain types of corneal graft patients,” Poole added. “In maybe 10 or 20 years’ time this may become the norm where we don’t need a human cornea and we can just take one out of the box.”
Poole added that Farley was “technically a very difficult first patient”. “I was prepared for things to be quite hard, but once the graft was fully attached and started to work, it was it was like ‘wow, this is really working well,’” he said.
Prof Sir Stephen Powis, the NHS England national medical director, welcomed the new approach. “The use of artificial cornea transplants is an exciting and innovative step forward in eye care, which has the potential to benefit many patients needing treatment to improve or restore their vision,” he said. “It could provide an additional treatment option for those waiting for donated transplants, and it’s heartwarming to hear of patients like Cecil already benefiting from its use.”
NHS Blood and Transplant says that to meet all surgery and research needs, it requires a weekly stock of 350 eyes. Between April 2021 to March 2022 it received on average 88 donations a week.
According to the NHSBT transplant activity report 2020-21, as of 31 March 2021, 10% of people had who joined the organ donation register had chosen not to donate their corneas – something Kyle Bennett, an assistant director for tissue and eye services at NHS Blood and Transplant, said could be down to the emotion and symbolism that people attribute to the eyes.
