Left to right switch over corneal auto-transplant
How do you restore sight in a patient who is blind in one eye due to end stage glaucoma (this eye has a healthy cornea) and is almost blind in the fellow eye due to a dense corneal scar after infection? The fellow eye has less advanced glaucoma and some macular degeneration but was the only eye with visual potential. The patient has not been able to see for 6 years and is dependent on others and needs to be led. The patient also comes from a country with standards of healthcare that are variable and hence long term survival of any treatment was another concern.
My approach to this case was to swap the healthy cornea from the right eye with the scarred cornea in the left eye. At the end of the surgery the patient had their own clear cornea and new lens implant on the left and their own scarred cornea on the right.
At the next day review both eyes were healing well with minimal inflammation. The patient was for the first time able to read letters from the vision chart and could walk unaided. He was incredibly emotional that after 6 years some sight had been restored. Vision wont be perfect due to glaucoma and macular degeneration, but some vision will improve his quality of life and help him regain his confidence and independence. An added bonus is the fact that he cannot reject his own tissue and hence rejection in the long term wont be an issue once things have healed. A rewarding case for me and him.