September 1, 2008
By ELLEN FREEMAN ROTH
Prosthetic lens a sight saver for Iraq vets
Henline, a 36-year-old Army staff sergeant serving in Iraq,
was riding with four other soldiers when their truck was hit
by a roadside bomb. The San Antonio, Texas, resident was the
only survivor of the April 2007 attack, but he sustained
severe burns over 38 percent of his body, primarily his
face, head, and left arm.
was badly damaged, and over time his other eyelid wouldn't
close because it was pulled open by healing skin grafts,
leaving his hazel eyes exposed to the elements and painfully
For a year,
he wore goggles and smeared his eyes with ointment and
"It was like
driving in the rain without wipers," he said.
Then he tried
a "liquid bandage" developed by a Boston researcher, which
had been used for several years on patients with diseased or
damaged corneas, but not on combat victims. The results were
"I saw 20/15
right off the bat," he said in a recent interview.
like Henline's have led the Army to begin using the device,
which resembles a large contact lens, more widely.
Ophthalmologist Dr. Perry Rosenthal of Needham, who invented
the lens, trained an Army optometrist to fit it at a clinic
at Brooke Army Medical Center in San Antonio.
Boston Ocular Surface Prosthesis, the lens rests on the
white of the eye and forms a dome over the cornea - the
transparent, curved structure at the front of the eye that
is instrumental in focusing light and has the richest nerve
supply in the body. The space between the cornea and the
lens is filled with artificial tears that bathe the eye and
allow the cornea to heal somewhat.
who have lost their eyelids in incinerating roadside
explosions, our device is often the only option for saving
their eyes," Rosenthal said. The device also has been used
to preserve and restore vision in soldiers with corneal
properly, the cornea must be perfectly smooth and hydrated.
When eyes dry out, irregularities, called ulcers, can form
on the surface of the ultra-sensitive cornea, damaging
vision - sometimes to the point of legal blindness. For
patients with eyelids, each blink can feel like sandpaper
rubbing on the eye.
proper ocular surface, the cornea would melt," said Dr.
Ernest Kornmehl, a Wellesley ophthalmologist and
spokesperson for the American Academy of Ophthalmology.
"This lens allows the [eye's] globe to stay intact."
had tried to preserve the vision of soldiers such as Henline
by frequently hydrating the eyes with ointment and
lubricating drops and even performing tissue transplants,
"I had some
soldiers who had severe burns in and around their eyes and
weren't responding to standard therapy, and we'd exhausted
all options," said Army lieutenant colonel Dr. Anthony
Johnson, associate program director at Brooke. Johnson
contacted another cornea specialist, who suggested
Rosenthal's lens, which had been used on about 2,000
patients over the previous four years. Johnson flew
Rosenthal to Texas.
first patient, a soldier who was unconscious, had ulcerated
"I put the
lenses on one day and went back the next, and the corneas
had healed strikingly," Rosenthal said.
Rosenthal's visit, 17 more soldiers have been fitted with
lenses. The Army's on-site clinic is fitting an average of
two patients each week.
his team custom-fit the lenses at the Boston Foundation for
Sight, a Needham-based nonprofit research and treatment
facility for corneal disease that Rosenthal founded. The
foundation uses its 2,000-lens sample library for custom
fitting, and fabricates each lens with a precision lathe.
For his trip
to the Army medical base, Rosenthal developed a universal
lens that doesn't require custom fitting. At the Army's
request, he and his team are designing an improved universal
lens for facial burn victims in military and civilian burn
foundation is also exploring collaboration with a start-up
in Cambridge to develop a lens surface that kills bacteria,
allowing it to stay in permanently. Now, Henline and other
recipients have to take their lenses out every night to
a lens just in his right eye. Eventually he'll wear a lens
in his left, which has no lid and is bandaged, and
additional plastic surgery aims to eliminate his need for a
lens in his right eye.
all his wounds is a long process " 'some day' is my motto,"
he said. So having his vision restored instantly with the
lens was momentous.
ecstatic," he recalled.
the universal lens during Rosenthal's initial trip, Henline
was custom-fitted at the foundation's Needham facility. "I
was so happy and wanted to go watch something. I got to
watch the Bruins play."
but seeing the action was a big win for Henline.