Dubai: A 49-year old Sri Lankan expatriate regained vision in one of her eyes that had been damaged due to glaucoma after a rare surgery conducted by an ophthalmic surgeon in Sharjah on June 29. Glaucoma is a fairly common condition and it deals with abnormally high eye pressure that can lead to the damage of the optic nerve, cornea and cause the loss of vision.
One per cent vision
Sudarshi Senani Halpandeni Hewa, a senior hospitality executive at a leading hotel group in Dubai is delighted that she can finally see from her right eye, especially after she had a failed stent placement (she had a tube implanted in her eye for the control of intra-ocular pressure) and corneal transplant surgery earlier.
“I had been suffering from severe glaucoma in my right eye since 2017, so much so that I barely had one per cent vision. I came to know of it because I had too many tears in that eye and couldn’t not face direct light in the eye. I had started hitting cars that were on my right side and the only option for me was to drive in the fast lane,” she said.
In 2017 she underwent a surgery to place a stent in the eye to drain out the tears a corneal transplant as that had become opaque and damaged due to her condition. However that failed.
Doctors refused to operate
“After that I visited at least four surgeons in Abu Dhabi, Dubai and Sharjah and all of them declined to touch my eye as they said it was too complicated. Someone then directed to me to Dr Sandip Mitra consultant ophthalmologist and corneal surgeon at the Al Zahra Hospital in Sharjah and despite the challenges of COVID 19, Dr Mitra operated on June 29. It’s a miracle that at my last dressing, I was actually able to see from that eye and have 70 per cent vision in that eye. I only need to take a few precautions like sleeping in the upright position, protectng the eye from any glaring lights by wearing dark glasses and I have been told that within a month full vision will be restored. I am looking forward to it,” said Hewa.
First time surgery in the UAE
Explaining the surgery carried out for the first time in the UAE, Dr Mitra said: “The patient’s case was complicated as she was already carrying a failed cornea transplant. Conducting a full cornea transplant surgery would be highly risky as the rate of rejection is very high. Besides full corneal transplants require about 16-30 sutures and this causes major irritation to the patient. So I chose this relatively new technique called Descemet Membrane Endothelial Keratoplasty (DMEK). While this has been carried out elsewhere in the world in the UAE there is no published antecedent about the use of this technique here.
“This procedure is carried out under general anaesthesia with a miniscule 2.2 mm incision where the diseased endothelium is removed and a thin membrane measuring 10-15 microns of donor corneal endothelial cells is placed. Instead of sutures, the endothelium membrane is fixed with a gas bubble. This creates a vacuum that makes the donor endothelium stick to the existing cells. The stem cells from the healthy donor corneal endothelium heal the existing cornea. After about a two days the gas bubble dissolves, as these cells get attached to the cornea. The main advantages of this type of partial corneal transplant is faster visual recovery, almost no sutures, less chances of graft rejection and better cosmetic appearance.”
Cadaver corneal membrane used
The graft used in this case was from a cadaver donor bank from US. Dr Mitra added that very stringent screening methods are used in selecting donor tissue that covers HIV, viral, bacterial and fungal screening including for COVID 19.
“After that the graft is transported in a special solution called optisol to prevent any bacterial, fungal or viral contamination and even after that we screen the graft at our microbiology laboratory before implanting it,” added Dr Mitra.
After the implant the only precaution the patient needs to take is to keep upright for a minimum of 48 hours post-surgery to enable the corneal cells to attach to the existing corneal membrane. The patient already has 70 per cent vision restoration in one week, and the complete vision will be restored within a month. This surgery is covered by most health insurances.