After six surgeries to his only seeing eye in the last 13 years, Mr. Cornelio Resendiz was running out of options. To Cornelio and his son Eduardo, a visit to the Lions Clinic, located at the California Pacific Medical Center in San Francisco, had become a monthly occurrence. Diagnosed with advanced glaucoma several years ago, Cornelio had already lost vision in his right eye and had only a small island of vision remaining in his left eye. He was referred to the clinic by Jason Bacharach, MD for ongoing care, and over the last 20 years, Cornelio and his doctors have tried everything to halt the progression of his disease and protect the remaining vision in his left eye.
Glaucoma is a condition associated with elevated eye pressures and damage to the optic nerve, the cable that connects the eye to the brain. Damage from glaucoma causes a gradual decrease in a patient’s peripheral vision; if the glaucoma is advanced, central vision may be affected as well. Unfortunately, damage from glaucoma is irreversible, so doctors and patients must work together to slow down its progression as much as possible with medicine and surgery.
To control Cornelio’s eye pressures, the only known modifiable risk factor to slow down the progression of glaucoma, specialists at the Lions Eye Clinic recommended surgery when eye drops alone were no longer enough. With the help of glaucoma specialists, doctors at the Lions Clinic put a small medical device with a tube inside Cornelio’s left eye to shunt fluid from the inside to the outside, thus lowering the intraocular pressure and helping to protect the eye from further glaucoma damage. The initial tube worked, but Cornelio eventually went on to need two more tubes to keep his pressure under control.
With every surgery, there are risks, and when stressed with multiple surgeries, the cornea can lose its ability to stay clear and compact. If our window to the world becomes cloudy and swollen, making it extremely difficult to see, another surgery in the form of a corneal transplant can restore sight.
After many glaucoma surgeries, Cornelio eventually sustained significant damage to his cornea and needed corneal transplants, a total of three over the last 13 years. When his most recent corneal transplant again became cloudy, his doctors knew that the chance of another corneal transplant, his fourth, having long-lasting success was slim. Given that this was his only seeing eye, Cornelio was desperate for options.
Fortunately, in 1992 the FDA approved the use of an artificial cornea called the Boston Keratoprosthesis for cases like Cornelio, where standard corneal transplants are not a good option. Unlike standard corneal transplants that use only tissue from human donors, the Boston Keratoprosthesis uses an “artificial cornea” made up of a clear medical-grade plastic optical stem and front plate, a titanium back plate, and donor tissue. It has the advantage of a quicker visual recovery and resistance of the optical stem from getting cloudy when compared to the standard corneal transplant and can provide another option for patients who are not good candidates for the standard transplant. Since 2000, over 7,000 of Boston Keratoprostheses have been implanted at centers across the United States and the world – including at the Lions Eye Clinic.
Before surgery, Mr. Resendez could barely count the fingers held directly in front of his face and seeing letters on the eye chart was impossible. With 20/200 vision post-surgery, Mr. Resendez is now able to more safely navigate through unfamiliar places and make out a friendly face. He will need close follow up to make sure his new artificial cornea stays healthy but Cornelio, his family, and his doctors at the Lions Eye Clinic are all committed to doing everything they can to make his latest surgery a continued success and maintain his vision of hope for a brighter, clearer future.
Jason Bacharach, a Glaucoma Specialist and the Medical Director at North Bay Eye Associates provides Eye Care for patients throughout the North Bay area. He works closely with CPMC and the Lions Eye Clinic to be sure every patient receives the Eye Care they deserve.
The Lions Eye Foundation of California-Nevada, Inc. (LEF) is a 501(c)(3) corporation that has been in existence over 55 years. For the past half-century LEF has come to the aid of needy residents of Northern California and the entire state of Nevada requiring eye surgeries. Sponsored by local community-based lions clubs, LEF has grown the initial 19 member clubs to 338 member clubs representing over 10,000 individual members. For More Information: www.lionseyefoundation.com.
LEF has partnered with California Pacific Medical Center to provide excellent eye care to those who could not otherwise afford it. In the fiscal year 2014-2015 alone, LEF provided over $6,000,000 of eye care procedures all at no-cost to the patients.
This Blog contains excerpts from an article written by Rachelle Rebong, MD and Margaret P. Liu, MD that appeared in the "The Lions Eye" Spring 2016 Newsletter, a publication of the Lions Eye Foundation of California-Nevada, Inc.