Pioneering surgery restores woman's sight

A blind woman has had her sight restored by a pioneering operation developed by a British surgeon which could ultimately end the need for corneal transplants from donors.

Jennifer Matcham, 64, lost her sight as a result of cumulative problems with her eyes. But within days of undergoing the new procedure, she was able to read close to the bottom of the eye test chart without glasses.

"One day I was blind and the next I could see. It was so sudden I could hardly believe it. My life has been transformed," Mrs Matcham of Liphook, Surrey, said.

The technique, developed by Michael Tappin, consultant ophthalmologist at the Royal Surrey County Hospital, is a refined version of the traditional corneal transplant in which the transparent surface of the eyeball is removed from a donor and stitched into the eye of the recipient.

The thickness of the cornea and the need for stitching with the traditional technique means patients have to wait up to 18 months until the eye settles down and they experience the benefits of surgery, and most end up with astigmatism (distorted vision) requiring correction by spectacles.

With the new technique, only the endothelial cells from the innermost layer of the cornea are scraped off and transplanted, eliminating the need for stitching and speeding recovery.

Endothelial cells pump water out of the cornea, keeping it clear, but when the cells are damaged the cornea becomes waterlogged and cloudy, a condition which accounts for up to half of the 2,375 transplants performed last year.

In future, doctors hope replacement endothelial cells may be grown in the laboratory, circumventing the need for donors and reducing the risk of rejection.

Mr Tappin said: "There are two problems with corneal transplants - distortion [because of the thickness of the transplanted cornea that has to be stitched in place] and rejection. This technique should overcome both. It is very exciting."

Of 15 operations carried out, nine had been successful, he said. It is called the TenCell treatment - true endothelial cell transplant. "The great thing with this technique is you burn no boats. You can repeat the procedure or do a traditional graft [corneal transplant]".

The next logical step was to grow endothelial cells in a laboratory, either from an existing cell line or harvested from the patient.

"People are working on that already. All we require for transplant is a functioning layer of cells, not a fully working organ [a heart or kidney]. So we think this could be the first application [of cells grown in the laboratory]."

Eyes are among the most difficult organs to obtain for corneal transplant and there is a waiting list for the operation. Relatives are reluctant to donate eyes because they are visible and an integral part of a dead person's face, compared with a kidney or liver, which is internal and invisible.

Mrs Matcham lost the sight in her right eye many years ago. She had cataract surgery in her one good (left) eye, which was successful until corneal problems developed in 2004.

Her sight deteriorated and by the summer of this year she was unable to see at all, and had obtained the paperwork to register as blind.

She had the operation to transplant the endothelial cells in July. For a break before the surgery, her husband, Frank, took her on holiday to Majorca, even though she was unable to see. "It was amazing. We toured the island by coach, visiting all these places. But I only saw them after the operation, when Frank showed me the pictures he had taken. It was fantastic - I was able to relive the holiday. I am one happy person."