Cornea transplants offer new hope

Cornea transplants offer new hope

Cornea transplants offer new hope

 

Innovative method improves results and drastically reduces recovery time

 
By Chris Zdeb, The Edmonton Journal Comments (3)
 
 

Jane Popow, 62, left, had her vision restored with a corneal transplant after being diagnosed with Fuchs’ dystrophy.

Photograph by: Shaughn Butts, Canwest News Service

When blurry vision prompted Jane Popow to visit her eye doctor, all she expected to get was a new pair of glasses. Instead, she was diagnosed with a condition the optometrist said would eventually make her blind.

The first thing a shaken Popow, 62, did when she got home that day was Google Fuchs’ dystrophy.

She found out Fuchs’ (pronounced fewks or fooks), is a condition of the cornea, the clear dome over the eye. Over time, the inner lining — or endothelium — of the cornea slowly loses the cells that pump impurities and fluids out of the eye.

This changes its structure and function, resulting in swelling, pain and eventual loss of vision.

Fuchs’ affects one in 1,000 people, mostly women, and has a hereditary component. Patients, many of whom mistakenly believe they have cataracts, are usually diagnosed after age 50.

Popow was relieved to read that with a corneal transplant, the condition can be cured.

Unfortunately, there’s a shortage of donated corneas, and some patients can wait as long as five years for a transplant. Worse yet, the traditional transplant method can leave them significantly visually impaired for a year afterwards.

“Your risk of falls goes way up, so hip fractures and things like that go way up,” says ophthalmologist Dr. David Climenhaga. “Managing your diabetes becomes difficult if you can’t see the insulin in your syringe properly. All those health issues kick in when you can’t see, so there’s a big quality-of-life issue.”

For the past year, Climenhaga has been doing a relatively new type of laser corneal-transplant surgery known as Descemet’s Stripping Automated Endothelial Keratoplasty or DSAEK, following the lead of doctors in Toronto and Brandon, Man.

The procedure, which involves splitting a patient’s cornea in preparation for the graft of a donor cornea, is done with a modified version of the machine used in Lasik vision-correction surgery, and requires few or no stitches.

It’s virtually painless, the potential for infection is reduced because the surgeon makes a shallower incision, and because of the angle of the cut, the patient has less astigmatism afterward, Climenhaga says.

“Two weeks later, people are often back behind the wheel with driving-functional vision,” he adds. “It’s a dramatic change in recovery time.”

The wait for donated corneas, however, hasn’t changed.

Popow was on the waiting list for almost a year before her first transplant in 2007. The wait for her second was about the same.

“It was really terrifying before the first transplant because I couldn’t really do anything,” she says. Her vision continued to deteriorate until it was like looking through glasses smeared with petroleum jelly.

“I couldn’t drive, I couldn’t read. I’d get lost in a store if my husband wasn’t with me. I couldn’t go up and down escalators because I had no depth perception, so I fell a lot. I fell up steps all the time.

“I felt really, really helpless and isolated.”

Life was better after the first transplant, but it was only after surgery on her other eye that it became more normal, she says.

Popow is still not driving, but she can read again — large print because it’s less tiring.

Between 420 and 430 people are on the Edmonton waiting list for a corneal transplant, Climenhaga says. About 75 transplants are done each year, though numbers can fluctuate from a low of 15 to 20, to a high of 90.

“It’s a shame that there just are not corneas available when you can open up the obituaries page in the newspaper any day of the week and see more than enough corneas to satisfy the weekly need and they are not being donated.”

Popow has always been an advocate of organ and tissue donation.

“I understand and respect people who aren’t (donating) because of their religious or moral convictions. … But people who would donate their eyes, but don’t get around to it (signing a donor card), or people who don’t even think about it, those are the people that bother me because it’s that important.

“I’m just so grateful to the unselfish people who went out of their way to donate their eyes for me. They really did give me my life back.”

For more information about Fuchs’ dystrophy and its treatment, visit www.fuchsdystrophy.com and www.corneatransplant.org

czdeb@thejournal.canwest.com

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