“
EYE CARE PRACTITIONERS CAN REDUCE THE RISK OF CORNEAL TRANSPLANTATION FAILURE BY WORKING CLOSELY WITH TEAM PARTNERS IN RHEUMATOLOGY AND USING SYSTEMIC IMMUNE SUPPRESSION.” — Shahzad Mian, MD
Shahzad Mian, MD, examines patient Linda Bunker
Personalizing Complex Care
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After a 30-year battle with viral outbreaks that caused scarring
in her cornea, Linda Bunker met a multidisciplinary team at
corneal scarring. Also, the infection may have spread deeper
the Kellogg Eye Center that successfully performed a corneal
into the eye by the time she came to us,” says Dr. Mian.
transplant.
“Most patients who come to us have less severe disease."
An outbreak of a viral infection in the eye can be serious,
“She had inflammation and significant vision loss from
Due to her complex situation another expert was enlisted–
progressing deep into the eye and possibly leading to the loss
Rheumatologist April Marquardt, OD, MD, Adjunct Clinical
of the eye, says Shahzad Mian, MD, Ophthalmology Professor
Assistant Professor of Rheumatology at UM.
at UM and Associate Chair for Education. Infections in the
cornea, or keratitis, may be caused by viruses, bacteria, or
for a rheumatologist, and that makes her a particularly valuable
injuries. These infections can cause severe ulcers that result in
member of the team. Dr. Marquardt regularly sees patients at
scarring, abnormal blood vessels that invade the cornea, and
Kellogg. “As a rheumatologist and optometrist, I understand
nerve damage. These complications can increase the chances of
the role that immunosuppression medications can play in the
rejection and failure of a corneal transplant, says Dr. Mian.
prevention of transplant rejection,” says Dr. Marquardt.
In the past, Ms. Bunker had responded to treatments of
Dr. Marquardt’s background in optometry is very unusual
She prescribed and monitored systemic medication to
topical antiflammatory drugs and oral antiviral drugs. However,
reduce the risk of rejection and improve the chances of trans-
the outbreak that Dr. Mian saw was more serious, and included
plant success. After Ms. Bunker’s eye was stabilized, a corneal
a bacterial infection on top of her viral one. Due to her past
transplant was performed and there were no issues with
viral infections and current bacterial infection, she was at a
rejection.
higher risk for rejection if she underwent the corneal transplant
she needed.
than she could ever see in her life. Her vision is 20/30,
2 years after surgery,” says Dr. Marquardt.
“This week, the patient told me that she can see better
