Holland Foundation for Sight Restoration Selects UCI Health Gavin Herbert Eye Institute

The UCI Health Gavin Herbert Eye Institute is now the first ophthalmology program west of the Mississippi to offer ocular stem cell transplants for severe eye surface damage. 

This life-changing procedure, pioneered by Dr. Edward Holland at the University of Cincinnati, has restored vision for hundreds of individuals with serious damage to their eye surfaces. UCI Health cornea specialist Dr. Marjan Farid is the first ophthalmologist outside the Holland Foundation program to be trained in the complex treatment method.

Severe ocular surface disease can occur at any age, though it tends to impact younger adults. Often it’s caused by a workplace accident, involving contact with chemicals or extreme heat. A genetic disorder or autoimmune disease can also cause the body to attack eyes and eyelids, resulting in similar damage to eye surfaces.

Traditional therapies, including corneal transplants, don’t work for these patients because the damage is so profound that the cells necessary to support the healing process have been wiped out. To overcome this, Holland devised a treatment that involves transplanting donor limbal stem cells to the patient, then leveraging the best practices kidney transplant teams use to prevent the body from rejecting the new tissue.

The limbal stem cell transplant had been tried before but always failed until Dr. Holland learned to leverage immunosuppressant therapy, based on kidney transplant protocols to keep the body from attacking the newly implanted cells,” says Farid. “Dr. Holland’s program is the only one in the country that does this procedure well, and now we’re transferring that knowledge to UCI Health to multiply the impact.”

A complex procedure

Holland began training Farid in the procedure more than a decade ago, seeing patients and conducting surgeries alongside her at UCI Health. The Holland Foundation for Sight Restoration recently selected the eye institute as the first of five planned centers of excellence in severe ocular disease across the country.

Farid is now working toward increasing the number of patients with corneal blindness whose vision can be treated and restored.

The transplant is just one of many steps and procedures in a process that may take up to a year for each patient and requires the expertise of multiple specialists. First, a stem cell donor must be found.

Siblings are usually the best matches. A person with healthy eye tissue can safely donate up to half the limbal stem cells from one of their corneas because they will replenish themselves naturally.

Preparatory surgeries may be required to ready the patient’s damaged eye for a transplant. For example, if a patient’s eyelid has scar tissue attached to the eye’s surface due to injury or disease, an oculoplastic specialist would be needed. After the transplant surgery, patients follow a regimen similar to kidney transplant patients, which includes seeing a nephrologist for immunosuppression therapy and blood monitoring. Finally, the patient may need a glaucoma specialist to manage secondary eye issues.

As an academic medical system, UCI Heath is able to bring together all the specialists and researchers needed for successful treatment. Farid plans to add one more critical skill set to the ocular surface disease transplant team to support these patients.

“The catalyst to help us fully establish this team is a nurse transplant coordinator who will manage and coordinate the many different aspects of a patient’s care — getting medications, scheduling monthly or weekly blood checks, calling insurance companies to make sure the medications, surgeries and other procedures are covered, and ensuring that patients are being seen regularly by our team as well as the immunologist,” she says.

Envisioning the future

Last July, the Holland Foundation hosted a starstudded fundraiser to support the sight-saving services they provide and to help fund and expand these services at the eye institute.

“It was overwhelming to see the generous donations from our community,” says Farid. “I’m grateful for the support our donors and grateful patients have shown for the eye institute in general, and for our severe ocular surface disease program, specifically. This is just the beginning for us.”

She also hopes to increase the number of UCI Health ophthalmologists who can perform the procedure. “Just as Ed Holland trained me, I want to train our faculty so that we have an entire team of eye surgeons who can care for these patients.”

UCI Health has a waitlist of patients whose vision could be restored by an ocular stem cell transplant. This life-changing surgery also advances the eye institute’s vision of a world without blindness — something close to Farid’s heart because it reflects the legacy of her mentor, the late Roger Steinert, MD, chair of the UCI School of Medicine’s Department of Ophthalmology and founding director of the eye institute who revolutionized laser surgery techniques to prevent blindness and improve vision.

“It’s impossible to quantify all that I learned from Dr. Steinert,” she says. “Not only about ophthalmology and corneal surgery, but about how to be a good doctor, to be gracious and humble, to be a leader both academically and in the ophthalmology world. I know that in developing this program, I’m walking in his footsteps.”

A portion of the proceeds from the July event will be directed to University of California, Irvine, benefitting the Severe Ocular Surface Disease Program of Excellence at Gavin Herbert Eye Institute.