From two blind eyes it was possible to reconstruct an eye able to see, with a corneal autotransplantation enlarged to the sclera and conjunctiva. It is the extraordinary operation on a blind patient, performed for the first time in the world at the hospital Molinette of the City of Health of Turin dal professor Michael Reibaldidirector of the Molinette University Eye Clinic and by professor Vincent Sarnicola, one of the leading experts in the world of corneal surgery. For the first time in the world, a blind patient regains sight in one eye thanks to the blind other eye.
The emotion of the patient totally blind for 6 years
“When I woke up and started seeing the outlines of my fingers and hand, it was like being born again.” These are the first words of EB, an 83-year-old man who lives in the province of Turin, suffering from two serious and different eye diseases, which had led him to blindness for 6 years, after having managed to recover his sight at the right eye which, already two weeks after the operation (which lasted 4 hours), allows him to recognize objects, faces and to move independently. The patient had lost sight in his left eye for 30 years due to irreversible retinal blindness and , in the last 10 years, had progressively lost the visual function also of the right eye but due to a rare chronic pathology (ocular pseudo-pemphigoid), which destroyed the cornea and unfortunately also the ocular surface.
Traditional corneal transplant surgeries had failed
In recent years, the right eye had undergone two traditional full-thickness corneal transplants, both of which rapidly failed due to ocular surface failure. Full-thickness corneal transplant is the surgical procedure in which only the cornea that has lost its transparency is replaced with a healthy cornea from a deceased donor. “Normally the cornea has a much lower rejection rate than other vascularized organs, but in the presence of a widespread alteration of the entire ocular surface, as in the case of the patient, this risk becomes very high – explains Sarnicola -. In particular, damage to the stem cells of the limbus, the area between the cornea and the conjunctiva, determines the irreversible failure of the transplant”.
For the first time autotransplantation of the entire ocular surface
In this operation, for the first time in the world, an autotransplant of the entire ocular surface was performed, taken from the left eye, including not only the cornea, but also a part of the sclera and the whole conjunctiva including the stem cells of the limbus “The operation was performed by taking from the left eye, unrecoverable from a functional point of view, but with the cornea and ocular surface in good health, all the conjunctiva, all the cornea and two millimeters of sclera, in a single piece – explain Reibaldi and Sarnicola -. In practice, a third of the left eye was auto-transplanted into the right eye, which was then reconstructed and returned to seeing».
An operation that can be replicated
«The real novelty consists – specifies Sarnicola – in having enlarged the corneal transplant to the entire ocular surface, to the conjunctive-scleral tissues, which play a fundamental role in allowing the success of the transplant in particular conditions, as in the case of our patient. At the same time, the left eye was reconstructed with donor tissue for aesthetic purposes only. «The operation was extraordinary and the patient, today after two weeks he has resumed seeing and moves independently. We are very excited and expect lasting success in the right eye, because it has been reconstructed with the patient’s own tissues and therefore potentially safe from the rejection problems that have afflicted previous transplants», conclude Reibaldi and Sarnicola. Despite the exceptional nature of the operation, it may be replicable in other cases in the same conditions as the first operated patient.