Mediclinic Durbanville Day Clinic sees its first corneal transplant

Posted on 18 April 2019

Mediclinic took another step in its innovative day hospital strategy when doctors at Mediclinic Durbanville Day Clinic performed the facility’s first corneal transplant.

A patient who lived with chronic eye pain for almost a decade was treated in a single day, thanks to the expert care on offer at Mediclinic Durbanville Day Clinic.

“The day clinic approach is particularly beneficial for patients with urgent and debilitating eye conditions,” says Mediclinic Durbanville ophthalmologist Dr Leonard Heydenrych. “Patients who need eye surgery can come in, have their operation, and go home the same day. This is a major advantage for our patients, and it applies even when they require more complex surgery, such as a corneal transplant.”

Dr Heydenrych should know: he and his team recently performed the first successful full-thickness corneal transplant at the facility – and have plans to innovate even further.

Back in June 2015, Mediclinic SA embarked on a bold new strategy – to lead the way in providing expert care through day hospitals. Launching Mediclinic Durbanville Day Clinic was the first step in the process. Almost four years later, the facility is a thriving example of how a day hospital can accommodate procedures that allow for admission and discharge on the same day, while providing quality clinical care.

Dr Heydenrych says he and his surgical team regularly make use of facilities at Mediclinic Durbanville Day Clinic for cataract surgeries and other less complex eye procedures. But this is the first time the clinic has been used to perform a corneal transplant.

“Our patient was involved in a motor vehicle accident approximately 20 years ago,” he says. “She suffered severe trauma to the eye area, including corneal lacerations and extensive damage to the eyelid. She had an emergency corneal transplant, but due to the fact the she had damage to the eyelid, her graft was unsuccessful.”

Dr Heydenrych explains that for a corneal transplant to be successful, a patient must have an intact eyelid, which is able to close properly, and a functional ocular surface. “When her graft failed, she was able to see no more than large hand movements and only basic light perception. She then developed an irregular epithelium, due to the unsuccessful graft, and that caused significant discomfort. She lived with that pain for about 10 years.”

Why so long? Eye surgeons were reluctant to perform another transplant while her eyelid was unable to close, says Dr Heydenrych. It was only once the patient had surgery to repair her eyelid, allowing her to regain some sensation in her ocular area, that Dr Heydenrych was able to schedule her for corneal transplant surgery.

As the patient is from the Southern Cape, she had to travel to Cape Town’s Northern Suburbs to find her nearest corneal specialist. Dr Heydenrych is one of only four such specialists in the country.

The corneal transplant surgery was a success – and Dr Heydenrych says it is only the start. “Corneal transplant surgery has exploded in the past ten years. Remember, the first transplant was performed in about 1905, and it has taken the 100 years since then for us to realise that we don’t need to graft a full cornea in every case. We’ve now perfected the art of transplanting specific layers of the cornea.”

Lamellar corneal surgery has largely replaced full-thickness transplant surgery as a standard treatment worldwide, and is a regular part of Dr Heydenrych’s practice. “We performed a full-thickness transplant with this patient, as it was indicated for us to do so – she had extensive damage and the entire cornea was affected. But as a general rule, only about 10% of corneal transplant cases worldwide require a full cornea to be successful and effective.”

Now that the facility has experienced its first corneal transplant surgery, he plans to introduce these innovations to Mediclinic Durbanville Day Clinic in the near future.

The day hospital strategy is designed to provide simple, speedy and expert care at an easy-to-access healthcare facility, with a streamlined admission process. Tailored admission and discharge times further minimise waiting periods, facilitating considerable savings in costs for patients and medical aids alike, while ensuring quality clinical care. Situated alongside a fully-equipped hospital, such as Mediclinic Durbanville, these day clinics have access to supporting services, such as radiology, pharmacy and pathology.

Mediclinic Durbanville Day Clinic is equipped with 26 beds, three theatres and a full-functional gastroenterology unit with two procedure rooms.

 

 

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