- A cutting-edge eye surgery has been performed at Groote Schuur.
- An estimated 150 patients at the hospital need to the procedure.
- The procedure was a first for South African surgeons.
A Claremont woman who this week became the first patient in South Africa to have a corneal neurotisation procedure done by doctors at Groote Schuur Hospital, says she cannot wait to get her independence back.
"I'm looking forward to gaining back my independence. Its been a while since I drove a car, and to get back behind the wheel soon is exciting," said the 40-year-old Ingrid Barge after doctors completed the medical procedure on Tuesday.
In September last year, Barge suffered a stroke that affected her trigeminal nerve. She lost all sensation in her right eye and then developed a condition called Neurotrophic Keratopathy.
Barge said her eye kept getting irritated.
The cutting-edge surgery, carried out by Dr Hamzah Mustak and Dr Ben Moodie, requires a collaborative effort with an ophthalmologist and plastic surgeon to restore the nerve supply to the cornea - the transparent covering of the eye that allows light to enter.
The cornea is rich in nerves and requires these to maintain a healthy surface. Yet, there are several ways the nerve supply to the cornea can become damaged, said Mustak.
"If the nerve supply is damaged or absent the cornea cannot maintain its integrity resulting in erosion of the corneal surface and eventually scarring and visual loss. There is a novel surgery described whereby a donor nerve graft is harvested to restore the innervation of the cornea."
The nerve is taken from the patient’s leg, he adds.
In the surgery, the graft is attached into the nerve supply of the opposite side, tunnelled across the bridge of the nose, and then passed through the eyelid of the affected eye. The nerve is then carefully divided into several branches, and these are tucked into little pockets created at the edge of the cornea, explained Mustak.
New nerve branches will grow into the eye during the following six to 12 months.
This kind of damage to the cornea is often difficult to treat and can result in vision loss. Groote Schuur alone has around 150 patients in need of the surgery.
"I hope this will be the start for more patients to be able to get the surgery done at Groote Schuur Hospital," said Mustak.
He travelled to Los Angeles to train in how to perform the surgery.
'I'm super excited'
Moodie is a Plastic and Reconstructive Surgeon based at Cintocare Hospital in Pretoria. He was mentored by the Chief of Plastic Surgery at Indiana University, Professor Greg Borschel, who is a pioneer in the field of corneal neurotisation. He collaborated with Mustak and the Department of Ophthalmology at Groote Schuur to learn the new technique.
Mustak said Neurotrophic Keratopathy means that the eye has lost its normal protective sensation, as well as the ability to keep the cornea healthy and well.
"This condition leads to recurrent corneal defects and ulceration which heals with scar tissue and ultimately leads to blindness.”
Barge said the surgery was about four hours long and absolutely pain free.
"I've been taking things easy since I've been discharged and currently I have an eyepatch on as to not infect the eye and for the healing to take place."
She said there was no aftercare needed, so she just needs to let her eye heal natural.
"My eye was constantly red, I had no tears in my right eye, there was no feeling. Yes, I had vision but there was no feeling in the eye.
"I'm super excited that the surgery has been a success," she said.
Barge added that she needs to keep the eye patch on for three months and thereafter she should have regained full sensation to her eye.
She had to leave her Au pair job and quit driving due to the ineffectiveness of her eye, adding that she cant wait to get behind a wheel again.
According to Mustak, the nerve will take between three to six months before it starts fully fuctioning.
"The procedure is performed at a few specialized centres internationally. This surgery provides some hope for these patients restoring the innervation required to maintain a healthy cornea," he said.