Cornea transplant gives high school girl her vision back
Posted on 12 February 2019
After helping a young patient see clearly for the first time in years, Mediclinic Pietermaritzburg ophthalmologist Dr Nicholas Davey discusses the benefits of increased organ donations.
By the time Banele Zikode approached Dr Nicholas Davey, the high school student had been suffering from poor eyesight for years. This is because she has keratoconus, a genetic condition that leads to gradual and progressive loss of vision.
Banele was prescribed glasses, but as the condition worsened, they ceased to make much of a difference. Her only option was a cornea transplant.
“Ideally, one’s corneas should be clear, and a very regular shape, to facilitate optimal vision,” says Dr Davey. “Keratoconus causes a weakness in the cornea, and over time, it begins to ‘cone’ – its shape starts to become irregular. This leads to blurred vision, and if untreated, can lead to total vision loss.”
Keratoconus is a condition best treated with a cornea transplant, and it’s not the only one. “Infections, ulcers – generally speaking, anything that causes opacity of the cornea could require a transplant.” Dr Davey says in his practice alone, he will see a patient who requires a cornea transplant every second month. And that’s where the challenge comes in.
Hospitals in the state sector accommodate every kind of condition and must be able to provide every kind of treatment. To do that effectively, these facilities prioritise urgent and life-changing eye care treatments, Dr Davey says. “Paediatric eye care, where early diagnosis is critical, is given high priority, and cataract treatments are probably next. Cornea transplantation is unfortunately way down the list.”
This is due to the high cost, specialist skills and significant resources required to perform this kind of surgery, but there is another reason: South Africa suffers from a severe shortage of cornea donors.
“There are many reasons, but people in SA don’t seem to sign up for organ donation very readily,” says Dr Davey. “When I did a fellowship in Canada, I discovered that anyone who applied for a new driver’s license was asked if they wanted to donate their organs in the event of their death, and their answer was reflected on their license. That made a huge difference. In fact, doctors there find they have an excess of corneas for transplantation.”
Banele’s surgery, which was the first cornea transplant to be performed at Mediclinic Pietermaritzburg, was made possible after Dr Davey received a cornea that had been donated to the Durban Eye Bank. The Bank receives donations from the public and makes the tissue available to doctors and their patients in the area.
“I am forever grateful to Dr Davey and Mediclinic Pietermaritzburg for their professional care and for helping me to see so much better,” she said.
Banele’s case is rare. Dr Davey says he currently requires four corneas for different patients and has been waiting for at least six months to receive one. South African private eye surgeons often then have to order cornea tissue from the United States. “This drives up the cost of the surgery tremendously,” says Dr Davey. “But without them, we wouldn’t have the material we need to treat our patients.”
Patients who need a cornea transplant may not have the option of ordering the tissue from the US, due to the high cost involved. Even those on medical aid will face a co-payment, as local insurers will typically only cover a portion of the cost, says Dr Davey.
A donated organ can make a huge difference in someone’s life, says Dr Davey. To register as an organ donor, contact the Organ Donor Foundation of South Africa (ODF) on 021 426 0198 or www.odf.org.za