They're Coming For Your Eyeballs

W.L. Gore, one of the world’s most innovative companies, is hunting for new product lines—and reinventing itself in the process

- Drake Bennett

Scrubbed in and gowned, Esen Akpek perches on a stool over a surgical table, her blue-gloved hands miming the procedure she’s about to perform. In front of her, fixed in the beam of her operating scope, the eye of an anesthetized female rabbit bulges through a slit in a surgical drape. A video screen mounted near Akpek’s head shows the feed from the scope: the albino eye, lids pried open, glares out like the Eye of Sauron.

Akpek is a professor of ophthalmology at the Johns Hopkins University School of Medicine in Baltimore. One of her specialties is corneal replacement, in which she substitutes the thin, transparent layer at the front of the eye with a donor or artificial one. Compared with the retina’s specialized neural network or the iris’s quicksilver diaphragm, the cornea is a simple piece of biological equipment. Its clarity allows light to enter the eye, and its curvature helps focus that light onto the retina, where it becomes the images we see. But the cornea’s simplicity belies its importance. Damage to it, through disease or trauma, renders millions of people sightless—a 2017 study in the Lancet Global Health ranked this the fifth- leading cause of blindness. Today’s operation is a test of a promising artificial cornea.

The procedure begins with Akpek suturing a thin metal ring to the veined, white sclera to hold the eye in place. With a custom stamp, she inks on a gunfight like grid to guide the incision. Then, with a cylindrical blade and scalpels, she begins to excise the cornea. Occasionally she narrates the procedure. “I like this one,” she says of a concave cutting tool—a “spoon thing,” she calls it, in her Turkish-accented English. Onscreen her movements are decisive and quick; observed directly they’re mere twitches, the gestures of a ringmaster directing a flea circus.