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"Looking into the eye is like looking into the cosmos"

Modern corneal transplant surgery is precise, fine-scale and gives usually a rapid visual improvement. But for patients whose vessels have grown into the cornea, there is a significant risk of transplant rejection and vision loss. Eye surgeon and researcher Branka Samolov attempts to find out how this part of ophthalmology can be fine-tuned for the good of the patient.

Branka Samolov.

Branka Samolov ended up at the right place when she got her first job as a licensed physician, a temporary placement at S:t Erik Eye Hospital. She enjoyed it so much that it led to residency training in ophthalmology and sub-specialising in cataract and cornea surgery.

"I enjoyed the handicraft, fine surgery appealed to me. In addition, the eye is an incredibly beautiful organ. Not only the visible part of the eye, but the inside too. Looking through the pupil is a bit like looking into the cosmos," says Branka Samolov, Senior Consultant at St. Erik Eye Hospital and researcher at Karolinska Institutet.

She thinks that even though the eye is a small organ, it has everything needed to satisfy ones curiosity. There are more illnesses than one might think of affecting our eyes. The pathology and symptoms can be limited to the eye, but may as well reflect a dysfunction in other even remote organs.

At present, Branka Samolov is a cornea surgeon, Corneal Service Director, a researcher and the Chair of the Steering group of the Swedish Cornea Register, one of Swedish National Quality Registries.

An eye close-up.
A healthy cornea is transparent. Photo: Istock

In-growth of vessels in the cornea affects vision

A healthy cornea is transparent and devoid of vessels. Blood vessel ingrowth in native cornea as well as in a transplant threatens the visual ability of the patient. Corneal neovascularisation can be caused by infection, inflammation, degeneration, hypoxia, injury or neoplasia. At present there is still no fully effective treatment for this medical problem.
 

 An illustration of the eye in cross section.
The cornea covers the front portion of the eye. Illustration: Fidelity

Performs clinical reserach 

In the early 2000s, the research field of neovascularisation was at its peak and Branka Samolov was drawn to it too. Her thesis in 2010 showed that corneal neovascularisation appears to be regulated both by different signaling molecules and by mechanical influence of the cells involved. Today she performs clinical research.

"Modern corneal surgery is more precise and fine-scale. Today it is most often possible to replace only the sick/injured part of this 0.5 millimeters thin delicate tissue. In this way the risks and complications are significantly reduced and visual recovery and prognosis ameliorated", says Branka Samolov.

Approximately 700 corneal transplantations are performed in Sweden yearly, corresponding the rate of this treatment in Europe as a whole. The Swedish Cornea Register collects patient data regarding corneal transplantation since 1996. It represents a central source of evidence based follow up and data analysis, contributing in research projects as well.

Branka Samolov

Title: Senior Consultant and Corneal Service Director at St. Erik Eye Hospital as well as researcher at Karolinska Institutet. Clinical and research supervisor
Research field: Cornea and corneal transplantation
Motto: "There is no certainty, without doubt.", freely translated words of Tage Danielsson.

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