Blind World Magazine

Corneal Blindness.
Cornea implant moves to second stage with success.

October 22, 2005.
Kansas City Star, MO.

SPRINGFIELD, Mo. - Today, Ginger Flower can see.

She sees things she could never see before - the hands of a wall clock, the fine features of her daughter's face, the red tea mustache on her grandson's upper lip.

A congenital eye condition left Flower legally blind most of her 40 years.

This month she completed artificial cornea implant surgery and began a life of new sight - beginning with the faces of nurses in her recovery room.

"I never expected to see this good," Flower said from her bed in outpatient recovery only 20 minutes after surgery.

"I can already see better than I have in my life."

She excitedly pointed out objects for the first time - the yellow cap on a nurse seated across the hall, the wall clock reading 2 p.m. A woman at the nurse's station - "She's got blonde hair. ..."

Before Flower finished scanning her curtained room and the hallway beyond, she had everyone in the recovery room crying.

Her doctor, Shachar Tauber, was pleased with the results. Follow-up visits in the coming months will tell him just how much vision was restored, he said.

"Before, I could not see in and she could not see out" through the left cornea, he said. Using magnifying instruments, "Now we can see in, and she should be able to see out."

Flower was Tauber's first of several patients in Springfield to undergo the two-step artificial cornea implant surgery - which Tauber says is a second chance for the corneal blind.

At least 10 million people worldwide suffer from corneal blindness, according to world health officials.

The cornea is the clear tissue covering the front surface of the eye, Tauber said. It provides physical protection for the eye and part of the eye's focusing power required for sight.

When the cornea is damaged by injury or disease, scarring and inflammation can reduce the passage of light and obscure vision.

Doctors sometimes can restore sight by transplanting a donated human cornea. About 100,000 people worldwide receive human cornea transplants every year - 40,000 of those in the United States, experts say.

About 20 percent of those 100,000 transplant cases are unsuccessful, sometimes because the body rejects new tissue, Tauber said. Artificial implants offer hope to many of those patients like Ginger Flower.

The Mansfield woman was born with a rare condition, aniridia, marked by the absence of an iris. She also has scarring of the cornea, the clear "window" on the front of the eye that lets in light and helps the eye focus.

As a child in school she studied from large-print books. But in time even that became difficult without a magnifying glass. As an adult she was declared legally blind, able to distinguish only light and color.

Flower's mother and older sister were also born with the condition, but human corneal tissue transplants failed.

Given family history, doctors had always discouraged Flower from trying it. Tauber, a cornea and refractive specialist and director of research at St. John's Clinic Eye Specialists, felt she was a prime candidate.

He had done several of the surgeries before moving to Springfield last year, with good success.

The procedure is done in two steps, three months apart to allow the eye to heal.

In the first surgery July 22, Tauber made an incision at the top of her left eye and inserted the artificial cornea into the damaged one. The AlphaCor implant, made by CooperVision Surgical of Western Australia, is a small, flexible plastic disc. The middle part is clear and acts like a lens, just like the natural cornea.

The white outer rim, or skirt, is spongy. During the first surgery Tauber stitched the implant to her eye, and over time Flower's own tissue grew into it and now holds it in place.

That step, alone, improved Flower's vision so much that she could distinguish the fingers on her hands and make out figures in the blocks of light and color that were always there.

After three months healing, Flower was ready for step two this month. It usually is done under local anesthetic, but Flower required general anesthetic to temporarily halt the uncontrolled back-and-forth eye movement - called nystagmus - that she also has as part of the congenital eye condition.

Before surgery began, Flower said, she said a prayer to herself: "I asked God to be with everybody there, and guide their hands to do what needed to be done."

During the 10-minute procedure, Tauber used a fine blade and scissors to remove the circle of old cornea tissue concealing the artificial cornea implant.

Flower will have to use special eye drops for the rest of her life to preserve the implant.

"Her eye has to live with the plastic, and the eye wants to push it out," Tauber said.

The implants cost about $7,800 per cornea, Tauber said. Medicare paid for her surgery; Springfield-based Rehabilitation for the Blind covers other costs.

More than 200 U.S. patients have received an AlphaCor implant since they were approved in 2002, so no one knows how long they last.

Flower had gone back to work a month ago as a certified nurse assistant at Glenwood Health Care in Seymour. The July surgery improved her sight enough that she could read the gauges when she took residents' vital signs. She hopes to return to Glenwood when her eye heals.

And she's set on taking a placement exam at Ozarks Technical Community College in Springfield. She wants to study business management and become a nursing home administrator.

One day, she'd like Tauber to do implant surgery on her right eye. But right now, she's waiting to use her new eyesight on her next grandson. Her daughter, Crystie Bloomer, is due any day.

While still in recovery, Flower began making plans for her homecoming - and seeing her husband, Crys, an over-the-road trucker.

The pair met when Ginger was 15, Crys was 17 - high school sweethearts. They just celebrated their 23rd wedding anniversary.

As she opened her eyes to new sight, Crys was somewhere between Springfield and California state. He'll be home soon, she said, and she can't wait.

"I haven't seen him very clear, lately."

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