First Angolan Cornea Transplant

I (John) saw this patient for the first time on friday after she had been struggling with her painful eye problems for over a year (I still get bad cases on friday afternoons , why does everyone in the world wait till friday to come to the doctor).  She is 18 years old and was facing the prospect of a life with painful, blind eyes.

Here you can see that her right eye is perforated. That brown lump is her iris (colored part of the eye) escaping through the large hole. This situation is very dangerous and she may lose the eye to infection or bleeding as there is fluid leaking from the eye.

 Her left eye is also involved and may experience a similar fate if I can't figure out how to stop the disease that is taking her vision.

       

                                  Thanks to my friends at Global Sight Network, I have glycerol preserved corneas to use for just such cases. I took her to the operating room and performed a corneal patch transplant, the first of its kind surgery in Angola. There may have been other transplants done in Angola, but nothing like this. Its purpose is to save the eye. It may restore some vision, but it is not a regular vision restoring transplant. Think of it like a patch to fix a flat tire.

                                                  

 Here is a photo from the TV screen in our operating room. The glycerol corneas are much different than the normal fresh corneas I am used to using. It was much more swollen during the surgery and very stiff. The opaque nature of the graft may improve over time, but I'm not expecting perfect clarity.

 This is the appearance of the eye 1 day after surgery. With time the white color should fade and she may have more vision. On this day she was able to count my fingers across the room and she said her pain was gone.

So with the help of my friends (thank you Chris Croasdale for the donation of the materials, Trephines and cutting block and Global Sight Network for the cornea), This young woman has a new chance at having useful vision. With the help of my cornea consultants back in the USA, I think I have a good idea how to stop the process from coming back. We shall see.

I hope to be doing more of this type of surgery in the near future. I was really wondering if my training at Harvard in Corneal Transplantation would be useful here in Angola. This opportunity was a testament to the fact that it was not an accident that I ended up there for training. A special thanks goes out to my mentors at the Massachusetts Eye and Ear Infirmary and Loyola for their gift to me of a world class surgical education.