Dr. Claes Dohlman (right) looks over medical information with Dr. Ana Fernandez-Hortelano for patient Phyllis Blumsack (at left rear).
(Lisa Poole for The Boston Globe)
Dr. Claes Dohlman, considered the "founder of modern corneal science," recently received the Laureate Recognition Award from the American Academy of Ophthalmology for his contributions in restoring sight worldwide. And he won the Global Leadership Award from the Massachusetts Eye and Ear Infirmary, where he was chairman of the ophthalmology department. He was also chairman of the department at Harvard Medical School, which is naming a professorship in his honor. A native of Sweden, Dohlman, 85, has been at the institute for nearly 50 years. He recently spoke to the Globe's Bella English in his office at Mass. Eye and Ear.
Q: You are considered the father of modern corneal science. How did you get interested in the eye?
A: My father was chairman of the ear, nose, and throat program (at the university) in Lund, Sweden, and he wanted me to go in with him. I said no, indeed. I didn't want to be in a working situation of being a fellow in his program. So I picked ophthalmology and I've never regretted it.
Q: You just received the most prestigious award in the field of ophthalmology, in large part because of your development of the Boston Keratoprosthesis, or Boston KPro, which helps blind people see. It sounds almost biblical. How does it work?
A: It is essentially an artificial cornea. The concept is as obvious as putting a clear window on a house so you can see out. It occurred to surgeons at the time of the French revolution, and a number of people tried to develop it with disastrous results. Not until the last 10 or 15 years has it been safe. We have made design changes and developed a regimen with antibiotics and soft contact lenses. One of the most important things is that prophylactic antibiotics virtually eliminate infection. It came on the market in 1992, and it works in the majority of cases.
Q: So you can actually make a blind person see?
A: If the blindness is due to the cornea. There are a number of diseases affecting the cornea. If the diseases have caused scar formation, the patient can't see. A standard corneal transplant is the first option. However, in many cases this does not work. This is where an artificial cornea is useful.
Q: What happens when patients can suddenly see their family for the first time?
A: For me, it feels like a major award has been given to me. . . . For the patient, it can be hard to grasp immediately. They can become almost hysterically happy with tears and hugs or they can be confused, not really grasping what is happening to them. Unfortunately, we can have disappointments as well. There can be too much damage to the retina or optic nerve (glaucoma), not evident before the operation.
Q: What sort of diseases would benefit from the KPro?
A: Bacterial, viral, fungal infections. They affect people who work on farms, who pick citrus; there's a lot of fungus in the South. In the developing world it's primarily the herpes simplex type I. Virtually everyone has it in the body, and it can flare up as a cold sore in the lips, eye, etc. There can also be chemical burns and dystrophies.
Q: What is there left to do?
A: A lot. It's not a question of the design, but of understanding the biology of the tissue around the eye. It has to be fine-tuned. Every year, we have something new we introduce and change. We want to introduce this to the developing world. That's where the real need is. There are 12 million people in the world blind from corneal disease.
Q: Where have you operated?
A: I used to operate in India, Japan, and the Middle East. To be able to introduce the artificial cornea in Asia and Africa, particularly in Africa, is difficult because of a lack of physicians and education. We are setting up courses around the world to introduce doctors to this.
Q: Do you have a patent on the KPro? How much does it cost?
A: I have resisted taking this development to industry because there's nothing they can do except take money. We keep it here and I shamelessly sell it to whoever wants to buy it. It's $3,000. I put the money into an account, and I don't take a penny of it. It all goes to research and development. I have seven research fellows and that money pays for them. We give a lot (of KPros) away to other countries. I think a patent is pretty meaningless because we are changing this on a yearly basis.
Q: You're 85 years old and still work six days a week.
A: There's nothing heroic in that. I love this work.
Q: In the scheme of life, how would you rate the importance of the eye?
A: In the list of things people fear most in terms of doctors, blindness is just after cancer.
© Copyright 2007 Globe Newspaper Company.
