Tuesday, April 10, 2007

How I Spent My Saturday Afternoon



This gentleman had a corneal transplant done years ago in San Diego. The graft failed, which means it did not remain clear -- it turned white. A cornea is supposed to be clear, so that the light can shine through it. When it is opaque, the vision is poor. In his case, he could see light, and nothing more.

He came in because he was playing with his four-year-old son, who jumped up and banged his father's eye with his head. The eye ruptured, right along the interface where the graft had been sutured to the "host" cornea. Of course the sutures had been taken out years ago, but this area remained the weakest of the eye, and any significant stress would cause it to rupture right here at the interface.

It wasn't just a simple rupture though, since a bunch of the "guts" of the eye had also squirted out (Ewwww!) -- iris, intraocular lens, vitreous and more blood than anyone likes to see seeping out of an eyeball.

I spent about 3 hours getting everything sewn back together. This kind of eye surgery (actually almost all eye surgery) is done through a microscope (that's why it's called "microsurgery"). You can see that the sutures are thinner than the diameter of his eyelashes. Click on the picture or the diagram to enlarge them.

He's doing well now, and this photo is from yesterday. The goal was to simply put Humpty Dumpty back together again. There was no expectation that the vision would improve because of his previously failed graft. Luckily, I didn't need to remove the eye. He still has light perception vision, same as before the surgery. He's very happy to still have his eye. His other eye is normal.

What to you guys think? Want to see more of this kind of stuff? Click on "comments" below.

2 comments:

The Saipan Blogger said...

You're writing about the life on an eye surgeon living on a small Pacific island. That's one hell of a niche you've found. Not too many eye surgeon bloggers living in the Pacific.

Just keep doing what you're doing. It's a good read.

Sarah said...

Blekh! I think I would prefer a picture like that to come at the end ;D