Pushing the boundaries of eye surgery

After losing all vision in his left eye, Robert Arbuckle was willing to do everything to preserve sight in his right. Seeking out expertise and treatment in Boston, Italy and California – each offered a glimmer of hope – but was quickly extinguished. Despite Robert’s efforts, his sight continued to get worse.

It all started in 1995 when an adverse reaction to medication caused extensive burn damage to his body and eyes. His limbal stem cells, which regenerate the clear, protective covering over the cornea, were deficient. Dr. Clara Chan, a cornea surgery specialist, at the Donald K. Johnson Eye Institute, Toronto Western Hospital, transplanted limbal stem cells from Robert’s sister and another donor, but while recovering, Robert’s eye pressure skyrocketed – a situation that can lead to irreversible optic nerve damage and permanent blindness.

“Normally for complicated eyes such as his we place a tube into the eye to drain the aqueous and bring down eye pressure,” says Dr. Matthew Schlenker, a leading eye surgeon at the Donald K. Johnson Eye Institute. “But we could not see into his eye to confirm placement, and we were concerned the tube may become blocked.”

That’s when Drs. Chan and Schlenker decided to try something bold. In collaboration with Dr. Robert Devenyi, Co-Director of the Donald K. Johnson Eye Institute, they carefully planned a triple combined procedure, where they would replace the cornea, insert the tube, and clean out the vitreous in the eye. This procedure can only be performed by a few select centres. “We warned the patient that this was a heroic surgery with little chance of success,” Dr. Schlenker says.

To everyone’s delight, results far exceeded expectations. Once Robert recovered from surgery, his life was truly transformed. After years of being stuck in the house and driven to medical appointments, he could finally see well enough to walk, cook, drive and take care of his new dog. “It’s the best I’ve seen in 15 years,” Robert says. “It really was a miracle.”

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