Fifty-five cases of corneal transplant performed at SKMC

Since corneal transplantation procedure started at SKMC, fifty five (55) cases have been done by the corneal transplant team with excellent outcomes. SKMC is owned and operated by SEHA, the Abu Dhabi Health Services Company, which is responsible for the curative activities of all the public hospitals and clinics in the Emirate of Abu Dhabi.

The treated patients' ages ranged from 3 years old up to 63 years old, and about 60% of the patients were males. It is worth mentioning that ten cases were performed during year 2007 while 45 cornea transplants were performed during 2008, which reflects a four-fold increase during the program's second year of activity.

A very special occasion at SKMC, under the name of SKMC Corneas Day, was organized on 14 January 2009 to celebrate completion of the 55th case of corneal transplantation. All corneal transplant patients, SKMC management team leaders, and members of the UAE media were invited to attend the event. SKMC management had several conversations with the patients who discussed their satisfaction and wellness after the transplant surgeries.

The surgeries were performed for various conditions such as keratoconus, corneal dystrophies, scars, trauma and regraft. However, keratoconus was the main reason for corneal transplant representing up to 70% of the cases performed at SKMC, which is expected considering the high incidence of keratoconus in the UAE.

In February 2008, SKMC obtained the support of Abu Dhabi Health Services Company - SEHA to officially commence a Multi-organ Transplantation Program that would cover all the major transplant services such as kidney, liver, pancreas and cornea, and Dr. Abrar Khan has led this program at SKMC.

However, corneal transplantation preceded the creation of the program and first began at SKMC in June 2007. Corneal transplantation procedures are performed by a local surgeon, Dr. Saleh AL Mosabi, who completed five years of ophthalmology residency training at McGill University in Canada followed by one year of cornea fellowship to master the newer techniques in cornea transplant surgery. After corneal transplantation was initiated at SKMC, kidney transplantation followed in February 2008 and liver transplantation is planned to start during year 2009.

Dr. Scott Strong, Acting CEO of SKMC praised the efforts of the multi-disciplinary team of the Corneal Transplantation Service. He stated that "The corneal transplantation program is a significant advance in ophthalmology and transplantation for the Emirate of Abu Dhabi, the UAE, and the region. SKMC will continue to take the lead in transplantation care in the UAE , which includes corneal and kidney transplantation, offering current, up-to-date treatment protocols under the competent guidance and management of Cleveland Clinic."

"The goal of performing the corneal transplant surgeries is to reduce the medical requirement for overseas travel, offer world-class transplantation services to all UAE residents, and provide a convenient atmosphere to the patient as well as family members. Health statistics show that the family is a vital part of the healing process and SKMC and SEHA are happy to provide this service within our community," Dr. Strong added.

Dr. Saleh Saif Al Mosabi, Corneal Transplant Surgeon, said that "In the old days, most of the local patients who needed a corneal transplant used to travel abroad to international centers, which was very annoying socially for the local patients as they had to spend away from home at least 2-3 months to have their surgery abroad. Now, we are able to treat patients in the UAE rather than sending them abroad for treatment. This will result not only in limiting the suffering of the patients outside the country, but also in increased convenience and comfort for them and their respective families."

Dr. Saleh said "Most of our cases are done by a new technique using the air bubble technique known as 'Deep Lamellar Cornea Transplant' (DALK) which is state-of-the-art in the corneal transplant science. This technique involves using the air to dissect the different layers of the cornea to remove only the diseased part of the cornea and keep the healthy part, in order to eliminate the chances of corneal rejection. With the new technique, the chances of endothelial rejection dropped to 0% and that is the most challenging part of any transplant to both the patient and the surgeon."

Dr. AL Mosabi, who has been trained in Canada on this new technique, clarified that "The biggest risk in any transplantation is the body rejecting the new donated organ. The old techniques for cornea transplant have 15 to 40% risk of the body rejecting implanted cornea. However, the new technique makes the risk of cornea rejection almost zero."

SKMC has very strong connections with the major Eye Banks in the USA where the best quality of corneas are shipped under a strict procedure to preserve the sterility of the cornea until it reaches SKMC where additional tests would be conducted in the blood bank to the integrity of the sterile process was maintained at all times.

Dr. Al Mosabi further explained that "The normal process we go through is receiving from an eye bank in the US the cornea, which is taken from the donor within 12 hours of his or her death, as per a prior agreement between SKMC and the eye bank. The surgery should then be done within two weeks. The operation lasts almost two hours and we can discharge the patient from the hospital a day after the operation depending on his/her medical situation. We also have a close monitoring system to make sure imported cornea is in good condition ensuring its excellent quality."