{"id":117373,"date":"2024-11-21T02:00:00","date_gmt":"2024-11-21T08:00:00","guid":{"rendered":"https:\/\/www.unmc.edu\/newsroom\/?p=117373"},"modified":"2024-11-21T08:26:31","modified_gmt":"2024-11-21T14:26:31","slug":"a-gift-of-vision-eye-donation-benefits-patients-research-at-unmc","status":"publish","type":"post","link":"https:\/\/www.unmc.edu\/newsroom\/2024\/11\/21\/a-gift-of-vision-eye-donation-benefits-patients-research-at-unmc\/","title":{"rendered":"A gift of vision: Eye donation benefits patients, research at UNMC"},"content":{"rendered":"
\n

Stephanie Nigro was 23 years old and a recent architecture graduate when her ophthalmologist told her she had keratoconus, an eye condition that leads to vision loss.  <\/p>\n\n\n\n

\u201cI left there totally hysterical,\u201d Nigro said. <\/p>\n\n\n\n

In the time before computer CAD design, architects such as Nigro would create eighth- or quarter-inch images as they worked out their designs. Nigro, who had just moved to New York City, was facing the potential loss of both her vision and her career. <\/p>\n\n\n\n

Keratoconus results in the deterioration of the cornea over time. As the disease advances, the cornea thins and becomes more cone-shaped, like a football.<\/p>\n\n\n\n

Nigro soon learned that corneal transplants offered a cure for keratoconus. After taking time to build up her design company in New York \u2013 \u201cI don’t know if it was denial or just the energy of youth, but I just continued on with my life\u201d \u2013 she had her first corneal transplant five years later. <\/p>\n\n\n\n

This past year, Nigro, now retired and living in Florida, traveled to Omaha for her fifth transplant, following UNMC\u2019s Ronald Krueger, MD, who has worked with her for decades on retaining her vision. It was one of 3,000 surgical procedures performed at the UNMC Truhlsen Eye Institute last year, many of which are sight-restoring \u2013 including corneal transplants, cataract surgeries, retinal detachments and vision correction procedures. <\/p>\n\n\n\n

\u201cIt really gives a person hope, to know that these options are available,\u201d Nigro said. \u201cIt\u2019s important to realize that in the case of keratoconus, as well as other vision problems, there can be opportunities for a cure.\u201d <\/p>\n\n\n\n

\u201cThe first doctor I saw never said anything about a transplant. He never said, \u2018There\u2019s a cure down the road.\u2019 It was horrible. I left there feeling my life was over.\u201d <\/p>\n\n\n\n

Dr. Krueger calls the sight-restoring operations a profound confirmation of an ophthalmologist\u2019s mission. <\/p>\n\n\n\n

\"\"
Ronald Krueger, MD, is the McGaw Professor and Chair of the UNMC Department of Ophthalmology and Visual Sciences, director of the Stanley M. Truhlsen Eye Institute and board member for the Lions Eye Bank of Nebraska.<\/figcaption><\/figure>\n\n\n\n

\u201cVision improvement or restoration \u2013 as ophthalmologists, we are doing that all the time,\u201d he said. \u201cThe beauty of ophthalmology is that sight is so valuable to people, and if you do procedures where you can get a quick return of vision, it’s a profound experience, both for the patient and for the doctor.<\/p>\n\n\n\n

\u201cCornea transplants don’t immediately give good vision. It takes multiple months for the vision to come back. But cataract surgery, laser vision creation correction, you can give almost immediate vision, where people come the next day and go, \u2018Wow, I can see everything.\u2019 That is, honestly, a cool thing.\u201d<\/p>\n\n\n\n

For Nigro\u2019s most recent surgery, the donated tissue came from the Lions Eye Bank of Nebraska, where Karli Diggins earlier this year was named executive director.<\/p>\n\n\n\n

Diggins, who has been with the eye bank for three years as a tissue procurement specialist, took over the role in April. The Lions Eye Bank of Nebraska has been located on the UNMC campus since 1960 and facilitates approximately 250 transplants a year in Nebraska.<\/p>\n\n\n

\n
\"\"<\/figure>\n<\/div>\n\n\n

Diggins said the eye bank\u2019s staff specialize in two preparatory procedures \u2013 DSEK (Descemet\u2019s Stripping Endothelial Keratoplasty) and DMEK (Descemet\u2019s Membrane Endothelial Keratoplasty), as well as processing full thickness corneas for transplantation. She and Curt Coughlin, whom she called \u201cthe foundation of the eye bank,\u201d are the only two non-physicians in the state trained to prepare DMEK and DSEK corneal tissue.  <\/p>\n\n\n\n

\u201cIn the DMEK preparatory procedure, we peel the back membrane or layer of the cornea, and the surgeon transplants it directly into a recipient to restore their vision,\u201d Diggins said. \u201cIt’s one of the more recent surgery techniques \u2013 it results in a lot less recovery time for the patients and a much quicker response as far as being able to see.\u201d<\/p>\n\n\n\n

DSEK, an older procedure, involves taking a thicker portion of the back of the cornea to make a layered graft, which replaces more of the cornea than just the thin membrane, so it requires a little longer recovery time.<\/p>\n\n\n\n

The patient’s condition and the surgeon\u2019s input determine what type of surgery is best for the patient, Diggins said.  <\/p>\n\n\n\n

The eye bank has done DSEK since 2010 and has performed 2,182 grafts to date this year. The relatively newer DMEK procedure has been offered since 2017, with 527 grafts completed this year to date. <\/p>\n\n\n\n

(Coughlin, who has been on staff for 40 years, is not the eye bank\u2019s only stalwart. Staff member Cindy Retallick, a tissue procurement specialist, has been there 23 years, while Angie Bashus, the quality assurance coordinator, celebrated 20 years of service this year.) <\/p>\n\n\n\n

\"\"
The Lions Eye Bank of Nebraska team, from left, are Angie Bashus, Stephanie Kephart, Karli Diggins, Cindy Retallick, Andrew Bechdolt, Curt Coughlin and Melisa Pellman.<\/figcaption><\/figure>\n\n\n\n

The eye bank works closely with the region\u2019s ophthalmologists, including those at the Truhlsen Eye Institute on the eastern edge of UNMC\u2019s Omaha campus, Diggins said.  <\/p>\n\n\n\n

Dr. Krueger stressed that the eye bank is there to serve the entire community, although there are academic and research advantages to having the building on campus. As the chair of the UNMC Department of Ophthalmology and Visual Sciences and board member for the eye bank, he also is working to raise funds for a new facility.  <\/p>\n\n\n\n

\u201cThe clinical aspect of what the eye bank brings is self-evident, but there is research and education going on throughout the department of ophthalmology, and the eye bank helps with that,\u201d he said.  <\/p>\n\n\n\n

\"\"
Shan Fan, MD<\/figcaption><\/figure>\n\n\n\n

Currently, the Lions Eye Bank is advancing the work of Shan Fan, MD, assistant professor in the UNMC Department of Ophthalmology and Visual Sciences, who works on glaucoma devices and implants.<\/p>\n\n\n\n

\u201cWe have been supplying whole globes, for her to practice putting those implants in and getting data,\u201d Diggins said. <\/p>\n\n\n\n

Researchers who use the \u201cwhole globe\u201d \u2013 all of the eye \u2013 often can, when their research is complete, supply other parts of the eye, such as lenses and retina, to other research projects, Diggins said. So, one donation may end up supporting many areas of research.\u00a0<\/p>\n\n\n\n

Dr. Fan\u2019s research focus is glaucoma, a leading cause of blindness.  <\/p>\n\n\n

\n
\"\"
Shan Fan, MD, an assistant professor in the UNMC Department of Ophthalmology and Visual Sciences, works in her lab with Amos Wang. Her lab does research using donated eye tissue that is not suable for transplantation.<\/figcaption><\/figure>\n<\/div>\n\n\n

\u201cMainly, glaucoma is caused by high eye pressure, because high pressure can damage the optical nerve. This damage is irreversible,\u201d Dr. Fan said. <\/p>\n\n\n\n

\u201cOur glaucoma lab focuses on studies to better understand the causes of glaucoma and how that affects the fluid flow within the eye. We use this information to investigate medications and drainage devices to lower eye pressure and slow the progression of the disease.\u201d <\/p>\n\n\n\n

One of the lab\u2019s current studies pursues the effects these devices have on fluid drainage performed in donated human globes \u2013 how easily the eye\u2019s natural fluid (aqueous humor) flows out of the eye before and after putting the implants. <\/p>\n\n\n\n

\u201cThe eyeball is like a balloon in that it is filled with fluid under pressure,\u201d Dr. Fan said. \u201cThe aqueous fluid is created and flows inside the eyeball, and then out through its drainage system. If the aqueous flow has high resistance, the drainage system has issues, and it causes pressure that can damage the optic nerve. And in the early stage, there are no noticeable symptoms. That\u2019s why we call it the silent blinder.\u201d<\/p>\n\n\n\n

Dr. Fan\u2019s team is exploring different methods of reducing aqueous buildup by increasing aqueous flow through the inner wall of what is known as Schlemm\u2019s canal. They work with devices and stents as small as one millimeter in size, similar to the tip of a sewing needle or the thickness of a credit card.  <\/p>\n\n\n\n

\u201cWe measure the resistance of the fluid drains of the eye, how the flow gets through Schlemm\u2019s canal,\u201d she said.  <\/p>\n\n\n\n

Of course, research is only part of the advantage of an affiliated eye bank. \u201cAlthough the Lions Eye Bank of Nebraska is an independent eye bank, it is affiliated with the Lions Club and cooperates with eye banks across the nation,\u201d Dr. Krueger said. <\/p>\n\n\n\n

\u201cIf I have a transplant scheduled for a young patient, then I need a young cornea. What if my bank doesn’t have a cornea for me? Do I reschedule and hope that next time there will be a cornea available? The Lions Eye Bank of Nebraska can go nationwide and say, \u2018Hey, we have a need.\u2019 And a Lions Eye Bank in Wisconsin or in California can say, \u2018Yes, we can help with that.\u2019 <\/p>\n\n\n\n

Krueger notes that corneal transplants are the most frequently performed transplant surgery across the country. <\/p>\n\n\n\n

\u201cThey have the least chance of rejection. They have good availability of tissue. And they don’t really require special biomarkers to match with someone else. Was the donor healthy? Is the donated tissue somewhat age appropriate?\u201d <\/p>\n\n\n\n

The Lions Eye Bank of Nebraska\u2019s mission, restoring eyesight, would not be possible without organ and tissue donation, Diggins said. In fiscal year 2023, the bank had 430 eyes donated, and 235 in fiscal year 2022.  <\/p>\n\n\n\n

\u201cWe’re very thankful for all the donors that we get,\u201d Diggins said. \u201cThis is an ongoing effort that greatly increases our ability to provide tissue for these life-enhancing surgeries.\u201d <\/p>\n\n\n\n

Nigro said, \u201cThe option of having corneal transplants gives a patient hope, which is crucial to one\u2019s mental health. Of course, successful transplants also are coupled with the gift of independence.<\/p>\n\n\n\n

\u201cI don’t want to depend on my children. I want to be able to live my life. I’ve given up things in my life that I used to enjoy because of the keratoconus, sure, but the surgeries have had a big impact.\u201d <\/p>\n\n\n\n

Nigro said she is often frustrated by the lack of awareness of the impact of eye donation. <\/p>\n\n\n\n

\u201cIt is essential for people to be aware that when they donate, they’re not just giving a cornea. They’re not just giving good vision. They’re giving a person a life. The gratitude I have for people who donate the corneas, and the gratitude I have for the doctors and the procedures and the research \u2026\u201d <\/p>\n\n\n\n

She\u2019s also indebted to the eye bank. \u201cI don’t want to forget the Lions Eye Bank and how grateful I am to them,\u201d Nigro said.  <\/p>\n\n\n\n

Diggins knows that the idea of donating eyes may seem off-putting to some. <\/p>\n\n\n\n

\u201cMy goal is to create more awareness about what we do, the precision and care that is taken with these gifts, and all the good that it does,\u201d she said. <\/p>\n\n\n\n

And as a partner with the Lions Clubs International, the Lions Eye Bank of Nebraska can send out a call for certain tissue if needed or supply needed tissue to eye banks across the country and the world. <\/p>\n\n\n\n

\u201cThat’s an awesome partnership to ensure these gifts get used, because the goal is restoring sight, and we\u2019re excited we can be a part of that,\u201d Diggins said. <\/p>\n\n\n\n

Learn more about the Lions Eye Bank of Nebraska<\/a> and register to be a donor here<\/a> or at the Nebraska Department of Motor Vehicles.<\/p>\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"

The Lions Eye Bank of Nebraska, located on the UNMC campus, partners with the Truhlsen Eye Institute and UNMC ophthalmology 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