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"I can see clearly now"
On 25 February 2008, the Herald Express Newspaper in Torquay reported reported:
Foggy, deteriorating vision could have left Martin Macleod blind within a year.
But thanks to a new type of corneal transplant, currently only being offered at Plymouth's Royal Eye Infirmary, he now has completely clear vision.Martin, 61, from Chudleigh, started to notice his vision in his right eye was going cloudy a few years ago. The vision in his left eye was already poor after he contracted measles at a young age. "I got corneal dystrophy which crept across my right eye until I had little or no vision left in it. I would not have been able to see had it got any worse," he said.
The condition alters the transparency of the cornea, blurring the patient's vision. People who suffer from it notice a gradual deterioration of their eyesight and it can often feel like there is grit in their eye. Martin said: "I had to stop driving and my vision was becoming increasingly foggy. It caused problems looking at computers or books and newspapers - that was a problem for me because I collect books." Martin was referred to a consultant in Exeter and from there he was put on the transplant list. "Corneas are in very short supply. I was meant to have the operation in May last year but they didn't have any available," he said. But the extra wait meant Martin was considered an ideal candidate for a new type of corneal transplant being carried out at Plymouth's Royal Eye Infirmary. And last September he underwent the pioneering operation.
During the operation, part of the cornea is removed from the patient's eye and replaced by the donor one. An air bubble is used to press this new donor layer to the front of the patient's eye. Around six stitches are needed to close the incision and to seal up the opening where the irrigation tube was inserted. Standard corneal transplants require around 17 stitches because the cornea is cut out and replaced. Martin said: "It's like the difference between a clear and a foggy day. I didn't realise how badly my eyesight had deteriorated. If it had not been done I would not be able to see now. It seems like a bit of a miracle to me."
Consultant ophthalmologist and corneal transplant surgeon Nabil Habib explained: "This technique has transformed the management of patients requiring a corneal transplant. There are many benefits, including a shorter operating time for the patient, which is carried out under local anaesthetic, and a quicker recovery time with superior visual outcome."
Sue Bond, theatre sister at REI, added: "The procedure is phenomenal. It's blown us all away.
"But there is a shortage of donor eyes, as with all donor operations. Unlike other transplants, however, there is no problem with the donor being accepted as there is no blood supply involved - the success rate of corneal transplants is around 98 per cent. There is also no need to make snap decisions for loved ones because eyes can be removed up to 24 hours after death and can be kept for up to one month in a protective solution. Potentially four people can be helped from one pair of eyes."
www.thisissouthdevon.co.uk
Seeing a difference
On 4 February 2008, Helen Pearse, the health editor for the Plymouth Herald Newspaper wrote:
A woman who was practically blind in one eye and underwent a corneal transplant six weeks ago says she is "amazed" by the difference the operation has already made to her life. Maxine Blackman has been suffering from a rare eye disease, and said her lack of sight in her right eye was affecting her independence. In December the 68-year-old grandmother-of-three had an operation at the Royal Eye Infirmary to replace a layer of her cornea. Now, she says she cannot believe the difference in her sight. She said: "I can't believe the difference in six weeks and I just hope it keeps going. It's amazing." Maxine suffers from a condition known as Fuchs Corneal Dystrophy, which she says makes it feel like she is constantly looking through cotton wool, or a frosted window. She is sensitive to light, and even the weather affects how well she can see, meaning her independence was gradually seriously threatened.
But since the operation on December 19, Maxine already says she is regaining her confidence and feels a different person. She said: "My confidence is coming back, and I can feel a difference in me. I know there is a long way to go and there could be pitfalls, but I am doing all the right things. "The main difference has been light. I am not so light sensitive. Light isn't uncomfortable any more, whereas it was before."
Her condition means part of the layer of the eye's cornea does not function properly and lets water in, thus blurring her vision. In later stages of the disease, this water can cause blisters on the surface of the cornea which can rupture, causing extreme pain. Maxine's right eye is worse than the left, but at some point in the future it will catch up and deteriorate similarly, meaning she could face having the same procedure on the other eye.
Nabil Habib, consultant eye surgeon with Plymouth Hospitals NHS Trust, performed the operation on Maxine. Put simply, it involved the damaged layer of Maxine's cornea being removed and replaced with a layer of cornea from a donor. The Royal Eye Infirmary was the first in the country to carry out the corneal transplant using special automated equipment, and Maxine is only the 23rd patient to have the operation in the city over the last 18 months. The first few days after the operation, Maxine couldn't see out of her right eye - this was expected. She said: "It was like Fuchs was still there and the haze was very thick. It was the 12th day after the operation and I got up, went to the bathroom and thought it was definitely lifting. By December 30 the haze had gone. Then all of a sudden there was sight."
Maxine says the sight in her right eye is still distorted, but she's been told it will continue to improve over the next few months - which the retired Nuffield Hospital room service supervisor is excited about. After a follow-up appointment on January 21 Maxine was told that she may need some laser surgery on her eye in the future to clear some remaining residue, and then her sight will improve further. "The day I realised there was sight, albeit distorted, I walked around with a stupid grin on my face and made numerous phone calls telling people. It's been really quite exciting," she said. "And there has been no pain. There's been discomfort and scratchiness from the stitches, but there hasn't been any pain. I haven't even had to take paracetamol."
Now Maxine cannot praise Mr Habib enough. She said: "He is an exceptional man. He is a very clever man, and he relaxes you." Maxine already feels confident driving at night, which she never did before because of the glare from lights, and is now planning to return to her hobby of line-dancing. She said: "It's completely changing my life and I'm quite positive about the future. I'm hoping it will continue to get better, and it certainly seems like that's what happens."
Read the whole story at http://www.thisisplymouth.co.uk/ under news>health
City pioneers treatment for eyes
On 3 January 2008, the BBC reproted:
More than 20 patients have received pioneering treatment at a Devon hospital with new laser equipment.
Plymouth's Royal Eye Infirmary is the only hospital in the country currently offering the new corneal transplant procedure.
Sue Bond, theatre sister at the hospital, said: "The procedure is phenomenal - it's blown us all away."
The procedure, called endothelial keratoplasty DSAEK, can be carried out under local anaesthetic rather than general anaesthetic. The new laser enables the top layer of a donated cornea to be sliced off, rather than the whole one.
Corneal transplant surgeon Mr Nabil Habib said: "This technique has transformed the management of patients requiring a corneal transplant."
"There are many benefits, including a shorter operating time for the patient which is carried out under local anaesthetic and a quicker recovery time with superior visual outcome."
Read the whole story at http://news.bbc.co.uk/2/hi/uk_news/england/devon/7170094.stm
Great Gran's Joy after Sight Saved
On 27 December 2007, Diana Prince of the Plymouth Herald Newspaper wrote:
An 87-year-old Plymouth woman was able to see her great-grandchildren this Christmas - after winning a battle to receive sight-saving drugs on the NHS. Joan Frude, of Estover, spent almost £3,500 of her life savings on eye injections before health bosses agreed to fund further treatment. The climbdown came after her son Gordon - furious that his mother had been told to 'pay up or go blind' - lobbied local health authorities, MPs and wrote to Prime Minister Gordon Brown.
Mrs Frude was told in March that without treatment she was likely to lose her rapidly deteriorating sight within two months. But on Saturday she enjoyed a reunion of more than 60 family members spanning four generations, and said she was 'over the moon' to have her sight saved. "I would have been devastated if I couldn't see my family," she said. "I haven't seen them all together for years, so it's just lovely." Gordon added: "Sight is the most precious gift we've got. The injections have retained her vision so she can remain independent. That means everything."
Mrs Frude, who is already blind in her left eye, suffers from wet age-related macular degeneration (AMD), which is the most common cause of blindness in Britain. Plymouth Teaching Primary Care Trust (PCT) declined to pay, classing her eyesight as too poor to qualify under local treatment guidelines. When she and her family found out, they appealed against the decision and The Herald highlighted their story.
Their case was taken up by Nabil Habib, a consultant surgeon at the Royal Eye Infirmary, and Devonport MP Alison Seabeck. She has since received treatment at the Royal Eye Infirmary, in October and November, and is due for a further consultation next month. Mrs Frude said: "The injections have retained my sight so I can remain independent and in my own home. It means so much."
Read the whole story at http://www.thisisplymouth.co.uk/ under news>health
The Herald watches as City Woman has Corneal Transplant - Precious Gift of Eyesight
On 22 December 2007, Helen Pearse, the health editor for the Plymouth Herald Newspaper wrote:
For Maxine Blackman, 2008 will not only mean a new year, but also a new lease of life. The 68-year-old from Plympton suffers from a rare eye disease, and is practically blind in her right eye. But, after undergoing a corneal transplant at Plymouth's Royal Eye Infirmary this week, Maxine's new-found sight is expected to give her her independence back. The grandmother-of-three says the condition, known as Fuchs Corneal Dystrophy, makes it feel like she is looking through cotton wool, or a frosted window.
On Wednesday Maxine had the operation at the Royal Eye Infirmary (REI), conducted by consultant eye surgeon Nabil Habib. The REI was the first in the country to carry out the corneal transplant using special automated equipment, and Maxine was only the 23rd patient to have it done in the city over the last 18 months. No other hospital in the South West does this operation, and people from as far away as Scotland have been to the REI for it.
Consultant Mr Habib explained to me how it was going to work. In simple terms, a layer of Maxine's cornea, the bit that's damaged, was removed and replaced with a layer of cornea from a donor. Throughout all of this the patient is awake.
Mr Habib said: "Immediately after the operation Maxine's sight won't be good because of the air bubble, that lasts up to 48 hours. After that it starts to come back very hazy and then, between two to three weeks, it improves. It keeps improving more and more up to three to six months after the operation.
He added: "We have a shortage nationwide of corneas, and it's important for us to encourage donors. "We are also lucky here that we have the equipment from the League of Friends. The machine cost between £40,000 and £50,000. They have spent one-and-a-quarter million pounds on the REI in total and are absolute lifeline for us."
Read the whole story at http://www.thisisplymouth.co.uk/ under news>health
American Academy of Ophthalmology
Mr Habib attended the meeting in November 2007 at New Orleans. He also attended the Cornea Society meeting to share his results of sutureless corneal transplants with opinion leaders in corneal surgery. Mr Habib introduced endothelial corneal transplants to the region and is training many surgeons in this new technique.
Brighton
Mr Habib was invited to give a lecture on new treatments of eye diseases at the post-graduate teaching programme at the Sussex Eye Hospital in October 2007.
United Kingdom & Ireland Society of Cataracat and Refractive Surgery
Mr Habib attended the meeting in September 2007 at Harrogate. He presented a paper and a poster on new techniques in corneal transplantation surgery. He was also invited to speak at the laser refractive surgery debate session.
League of Friends of the Royal Eye Infirmary
In september 2007, Mr Habib accepted on behalf of the Plymouth Royal Eye Infirmary an Optical Coherence Tomographer from the president of the League of Friends, Baroness Foulkes. Mr Habib campaigned to acquire this advanced technology for the Royal Eye Infirmary to provide the best services in the region for patients with Age-related Macular Degeneration and Diabetic Retinopathy among other conditions.
