Blind World Magazine

Five year old girl may regain sight thanks to rare operation.

August 03, 2005.
KSDK, Missouri.

A five year old Kansas City girl may be on the way to regaining her sight thanks to a rare operation at a local hospital.

Doctors took a salivary gland from a young patient's mouth and put it into her eye in the hopes of replacing her tears, and improving her chances of getting a cornea transplant.

Sierra Guillen lost the ability to make tears after a severe allergic reaction to a seizure medication about two and a half years ago. Her eyes are now so dry, she's extremely sensitive to light, always rubbing them. And her corneas are so scarred she's become legally blind, able to see only colors and shapes.

But two weeks ago, doctors at Washington University School of Medicine began Sierra on a path that may help her regain her sight. In a 12 hour operation, Dr. Randal Paniello took a saliva gland from her mouth and transplanted it so it now drains into her right eye. If it works, Sierra could then have a cornea transplant and see again.

He'd read about the operation in an Australian medical journal ten years ago.

"I thought it was an interesting idea and tucked it away and said if I ever see anybody that needs that I'll have something up my sleeve for them," says Dr. Paniello.

Dr. Paniello's done the operation twice before, but never on someone so young. It involves microsurgery to attach the saliva gland to a new blood supply in the temple, a delicate operation that requires doctors to maneuver around critical nerves in the face.

"The things we worry about most are the little arteries and veins can get clotted and then the tissue fails and the whole thing doesn't work."

But Wednesday afternoon, Dr. Paniello ran a test and discovered it has worked. A small strip of special paper was placed in Sierra's eye to see if there's any moisture there. The reading on the paper was a five. Normal eyes measure anywhere from five to ten.

"She's all healed. She did great!" says Dr. Paniello.

Again, this is just the first step in helping Sierra see again. If her salivary gland transplant continues to work, her family hopes to schedule a cornea transplant in the next six to eight months. And they hope to have Dr. Paniello transplant a salivary gland into her left eye soon.

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