Perferation in Her Cornea

April 2009:

Yet another surgery to treat the Glaucoma...

Emily would be having the second cornea transplant and cataract surgery soon, but the pressure in her left eye needed to be brought under control first. At the last appointment with Dr. Kane, her eye pressure in the left eye was 28, normal is between 10 and 20. During an ultrasound of her eye, Dr. Kane was able to see that the valve and drainage tube was still working. Her eye was producing more fluid than the one tube could handle, so the plan was to put a second tube in to help drain the fluid more efficiently. However, a complication came up at the hospital even before she was in the operating room. Dr. Kane came to talk to us and check Emily out and was alarmed at what he saw. He believed that the weakened area of her cornea actually had a small perforation in it and if that was the case it would have to be taken care of quickly. He immediately called and spoke with Dr. Zaidman, her cornea doctor, and he agreed that if there was a perforation that it would need to be repaired.

The surgery took just over 3 hours and when Emily was in recovery Dr. Kane explained to us what he found. The lens of her eye was pressed up against her cornea and no fluid was in between, which meant that fluid was leaking out, basically her eye was deflating. A leak meant that there was a perforation. Because there was no fluid in between the cornea and lens, there was no space to implant the second tube. So the scar tissue surrounding the valve and first tube was removed to try and aid in the flow of the fluid. The perforation was fixed by using a procedure called Amniotic Grafting. Basically a small piece of preserved amniotic tissue, which is similar in make up to the layers of the eye, is used as a patch to help cover the area where the perforation is. I was once again amazed at how advanced our medical technology has become, but after doing some research on it I discovered that amniotic tissue has been used in surgical grafting since 1910 and in eye surgery since 1940. Just amazing!

Once the graft heals it will integrate itself into her eye and become transparent. But this is only a temporary fix. This new complication may change how quickly she will have the cornea transplant. She was scheduled for that surgery on June 4th, but I would be taking her to see Dr. Zaidman and would have more information then. The biggest risk right now is infection, if her eye were to get infected and pass through the tiny perforation, it would be disastrous for her. But she is on 2 types of antibiotic eye drops to make sure that doesn't happen. Once she has the transplant, that entire area should be replaced with the new cornea so we are trying to remain positive about the outcome and the vision she will have in that eye.

Just as it was back in February, Emmy's eye was bruised, swollen and red. But as usual she was just as happy as can be! It's heartbreaking as well as heartwarming to see such a happy little girl go through so much and always come out on the other side with a smile. She is definitely one special little girl!