Dr Edmondo Borasio consults to patients at the renowned Moorfields Eye Hospital, Dubai. A short time ago he caused a breakthrough in eye surgery by inventing a new technique, called Inverted Lasik, to cut the donor corneas for patients requiring corneal transplants.
What kinds of eye problems does the Inverted LASIK technique fix?
The Inverted LASIK procedure is indicated for patients with severe corneal diseases such as keratoconus, which require a partial thickness corneal transplant.
Self-medicating without seeking advice from your eye doctor may cause irreversible problems such as glaucoma. – Dr Edmondo Borasio, Moorfields Eye Hospital.
Partial thickness corneal transplants are called Deep Anterior Lamellar Keratoplasty and differ from the full thickness (penetrating) ones because they require the transplantation of only a layer of the cornea rather than the whole organ.
Are there any types of patients iLasik can’t be performed on?
Only patients whose back corneal layers (the endothelium) are healthy are eligible for the Inverted LASIK procedure. This applies to around 80% of the eyes that require a corneal transplant.
Is there any post-operative care procedure patients must follow?
Patients undergoing the Inverted LASIK corneal transplant should follow the same eye drop regime as those undergoing a full thickness corneal transplant, but they can typically stop using the drops a few months earlier since the procedure is less invasive. There is also less risk of developing a graft rejection since the endothelium is not transplanted.
What is the cost of these Inverted Lasik operations?
The cost for the Inverted LASIK procedure is slightly more than that of a conventional corneal transplant (Dhs 40,000).
What made you decide to innovate on the existing laser techniques?
I felt that current techniques were unable to provide the perfect match between the donor and the recipient cornea and therefore I drew a few diagrams to try to understand what the ideal cut should have been and then I thought about the way to achieve it with the current technology.
What motivates you?
The challenge of always trying to improve my clinical and surgical skills and meeting my patients’ expectations.
What made you choose the field of eye care?
I chose ophthalmology because I like anything that requires dexterity and precision and relies on hi-tech equipment. The main reason I chose eye care however is because I find it extremely rewarding to make people see better. What are the 5 worst habits people have that contribute to weakened eyesight?
1. Poor prevention Any sight problem in a child must be corrected before age 6-7. After this period the sight does not develop anymore at the level of the brain even if the physical eye problem is fully corrected.
This is called amblyopia or “lazy eye” and typically occurs due to astigmatism or differences present in the refraction between the two eyes. It may also occur in children who have a squint, or in the presence of a cataract or retinal problems
2. Self-medicating without seeking advice from your eye doctor. This may cause irreversible problems such as glaucoma
3. Eye rubbing This may cause irreversible weakening of the cornea (keratoconus)
4. Low cost laser refractive surgery in a non-hospital environment, putting the eyes at risk of infection or of developing complications
5. Marriages within the same family This brings up recessive genes which are otherwise harmless. A typical case is keratoconus, which is very common in the Middle East.
What are the top 5 things people can do to help keep their eyesight healthy?
1. Have your eyes checked by an eye doctor once a year after age 38. All children should be seen before age 3, or earlier if white reflexes are noticed in photographs or if the eyes do not seem to look straight
2. Never sleep or swim with your contact lenses on, to prevent serious infections of the corneas
3. Avoid eye rubbing If your eyes are itchy see an eye doctor who will prescribe appropriate anti-allergic mediation
4. Stop smoking and drinking alcohol, maintain a healthy diet, and exclude the presence of diabetes (which is very common in the Middle East)
5. Read in good light conditions and keep a minimum distance of 30cm from what you are reading.
Keratoconus is a degenerative disorder of the eye. Structural changes within the cornea cause it to thin and change to a more conical shape. This can cause distortion of vision, with patients often experiencing multiple images, streaking and sensitivity to light.
Keratoconus is typically diagnosed in adolescence and reaches its most severe state in the 20s and 30s. If it afflicts both your eyes, the deterioration in vision can affect your ability to drive a car or read normal print.
In most cases, corrective lenses will help you continue to drive and function normally. But further progression of the disease may require surgery, including corneal transplantation.
Keratoconus is the most common developmental abnormality of the cornea, affecting around one in a thousand people. It is prevalent in populations all over the world, but occurs more frequently in certain ethnic groups.
The exact cause of keratoconus is uncertain, but has been linked to enzyme activity within the cornea. Researchers suspect a genetic link, as the risk is greater if a family member has been diagnosed.
Follow us on
