Together on the path to optimal corneal transplants.

As a Tissue Specialist and researcher at Amnitrans Eyebank Rotterdam, Julia Nijenhuis specializes in preparing and developing eye tissue for corneal transplants.

Robert Jan Wijdh is a cornea specialist at the UMCG. Since 1997, he has played an important role in more than 5,000 corneal transplants. In addition, he contributes significantly to scientific research.

Eye bank

Julia: ‘At our eye bank, we receive donated eye tissue. Upon arrival, we first assess the quality of the tissue, and if it is suitable, we prepare it so that eye surgeons can transplant it. Offering corneas to surgeons is very easy online via the NTS application. The surgeon then indicates whether they agree with the offer.

DMEK

‘The surgeon can also indicate in the app if they are going to perform a DMEK, a surgical technique where only the innermost layer (lamella) of the cornea is replaced. For this, we detach the inner lamella of the cornea from the stroma (the middle, thickest layer of the cornea) and supply only this transplantable layer of cells. The lamella is only 10 micrometers thick and is so fragile that we have to work very precisely. We therefore use the no-touch technique, where you touch the tissue as little as possible.’

Collaboration in the tissue chain

‘I find the collaboration with the entire tissue chain very pleasant. Because the lines of communication are short, we can consult quickly—including with Robert Jan and his fellow surgeons—and work together to prepare the best available cornea for every patient.’

Request

Robert Jan: ‘If one of my patients needs a donor cornea, our planning office requests it from the eye bank using the NTS application. When registering, we can immediately indicate the timeframe in which the cornea is needed and whether there are any special requirements, for example regarding the size or HLA typing of the tissue. Then Julia and her colleagues go in search to a suitable cornea.’

Gold standard

‘DMEK has meanwhile become the gold standard for patients with a disorder of the corneal endothelium (the inside of the cornea, ed.). The beauty of it is that only a very small part of the cornea is replaced, which keeps the shape intact and allows vision to recover quickly and often completely. This invention has had a major impact on the success of corneal transplants.’

Future

‘For the future, there are even more promising techniques, for example with cell cultures and stem cells. In the field of surgery, I think we have already reached a kind of optimum, partly thanks to the accessible collaboration with the NTS and the tissue banks. I can already see what the transplant looks like in the app before the surgery. It is incredibly nice to go into an operation with peace of mind, without being faced with any surprises.’