Eye Bank restores sight to the blind through cornea transplant
By Sola Ogundipe
MESSRS Emma Akana, Sikiru Akinbanjo and Friday Akagbue are not relatives but were once united by a common destiny. They were not born blind, but each of them once lived in the world of the blind. But they can now see. Their sight was not miraculously or divinely restored, but through a time-tested scientific process known as cornea transplant.
Recounting their odyssey from the land of the sightless back to that of the sighted, the trio gave testimonies of hope to others with similar predicament.
For Akana, a septuagenarian and retired engineer who completely lost his sight previously, being able to see again is like a rebirth. “My life has changed,” he remarked. “Nothing can be compared to being able to move around freely without being assisted or led by someone because you cannot see.”
Speaking in Lagos recently at the Metropolitan Hotel, Victoria Island, during a special breakfast/fund raising meeting with the Vice President, Prof. Yemi Osinbajo, Akana recalled that after the successful cornea transplant, his sight was fully restored, and he has became active again in every sense.
“It is my personal miracle. After six years of living in darkness, I can see light again. I no longer have to lean on anyone to move around. I even drive myself,” he said with confidence, noting that gradually, his eyes have become clearer. “Since the day my sight was restored, I have not had any problem with my eyes. Five of us went for the operation, and none has had any serious complication.”.
At the event put together by the Eye Bank for Restoring Sight, EBRSN, to assist cornea-blind Nigerians restore their sight, Akana narrated how one eye specialist after the other told him that his condition could only be corrected abroad.
“Every doctor that examined me told me the same thing, which was that the treatment I needed was not available in Nigeria, but they were soon proved wrong, because it was here in Nigeria that I had my sight restored, and the operation was carried out by Nigerians.”
Expressing gratitude for the restoration of his sight, he urged Nigerians to seek the right information in order to have more confidence that more could be done for the overall benefit of Nigerians.
In his own account, Akinbanjo, a 75-year-old retired military officer, said in the search for restoration of his failing eyesight, he went endlessly from pillar to post, consulting one eye expert after the other, all to no avail.
“I had the first surgery, then the second, but there was no improvement. Then, it was discovered that my main challenge was a cornea problem and I was referred to a doctor at the Eye Bank for Restoration of Sight in Lagos. I had a successful cornea transplant surgery in 2013. I now see well.”
One of the greatest joys of the pensioner is seeing his grandchildren and great grandchildren. “I am so happy nobody got tired of coming to my aid to assist, or complained about my need to be led around. As a pensioner, it was not easy going about getting my money with somebody having to follow me and do all the running around. But now, with my sight back, I do it all myself,” he noted.
As for Akhabue, the youngest of the trio, a successful cornea transplant was just the second chance he had been searching for. “It is a long story. I just woke up one day and could no longer see,” said Akhabue who is now employed as a cashier/front desk officer with an airline. He informed that he was having eye problems previously and the complications made him lose his sight eventually.
“It was a very traumatic period for me and my family, but when I heard about the ESRBN and its cornea transplant initiative, I became hopeful again. What is significant is that the cornea transplant gave me a second chance. I signed up for the surgery and it was successful. My friends were initially sceptical and joked that I would be given cow’s eyes, but I did not relent and remained hopeful. And it paid off in the end. I advise anybody with eye problems to go to the hospital and see the eye experts and no one else,” he admonished.
Restoring sight to damaged eyes
The trio is just a handful of Nigerians that have benefited from cornea transplant in the country. Statistics from a recent study conducted at the Pacelli School for the Blind, showed that up to 60 per cent of the blind people at the facility would have benefited from corneal transplants.
To restore sight to damaged eyes, doctors often need to transplant the cornea from a donor’s dead body. The cornea is the clear front part of the eye, which lets in light and helps focus images on the retina. When it is damaged, as a result of injury or disease, a person’s sight deteriorates, sometimes to the point of blindness.
The first successful corneal transplant surgery in Lagos took place in 2010 at the Lagos State University Teaching Hospital, LASUTH, when two unidentified patients, benefited from the cornea of Mr Kola Shodipo, a 47-year-old man who died August 18, 2010.
Shodipo was the first Nigerian to donate his eyes for a cornea transplant. Prior to his death, Shodipo had pledged his eyes, which were removed hours afterwards, and the corneas used to restore sight to two individuals who had cornea blindness in one eye each.
Prior to this, all cornea transplants in Nigeria were done with corneas obtained from other countries, mostly from China. But since the ESRBN came into existence in 2004, not a single cornea had been harvested locally until very recently.
Indeed the gift of sight is precious and thousands of people the world over are having their sight restored through cornea transplants every year. However, since the first successful cornea transplant was reported in Olmütz, Moravia, (Czech Republic) in December 1905, the demand for corneas has increased drastically and even though thousands of people donate their corneas after their death, there is currently a chronic shortage in countries like Nigeria where there is significant number of visual impairment cases due to corneal blindness – a condition that is reversible through cornea transplantation also known as keratoplasty.
“Cornea transplants are successful sight-saving operations, with about 95 percent of grafts functioning after one year. More people could benefit from sight-saving transplants if more corneas were available,” said the Managing Director, The Eye Bank for Restoring Sight, Dr Mosunmade Faderin-Omotosho.
A Consultant Ophthalmologist, Faderin-Omotosho, said corneal blindness can be cured through corneal transplant by removing the damaged cornea and replacing it with a healthy one. However, she remarked that the challenge is getting a suitable system for collection of the corneas, processing it and distributing to the doctors. She called for enforcement of legislation while lamenting that majority of those that really need corneas cannot afford to pay.
She said those who suffer from corneal blindness can have their sight restored if they can receive a healthy cornea from donors. “As individuals, we can sign written permission for our corneas to be harvested at death, in order to restore the sight of a living blind person.”
Explaining that cornea transplant is very safe and effective, she noted that because there are no blood vessels in the cornea, rejection rate is very low. “Cornea blindness is reversible because it is just the front part of the eye that is damaged. When that part is damaged, the person cannot see, but with a successful surgery, which involves the replacement of the damaged cornea with a good one gotten from a dead person, sight can be restored.
“Those who suffer from corneal blindness can have their sight restored if they can receive a healthy cornea from donors. But for the cornea to be useful for a transplant, it must be removed within 12 hours after death with the consent of either the deceased, given before death, or the family members.
“You just want to be sure that the cornea is from a healthy person. The recipient must also be in good health. He or she can also donate because later on the cornea heals and all that is left is just see a line.”
However, persons blind from such conditions as glaucoma, complication of diabetes and hypertension on the eye cannot benefit from cornea transplant. Already, in view of the myriad of challenges confronting restoration of sight through corneal grafting, Nigerians need to embrace the practice of leaving a legacy of sight by pledging their eyes (corneas) before death.
Available of donor corneas
Calling for counsellors to talk to people to donate their corneas, she said cornea transplants were first carried out in the late ‘60s and early ‘70s in Nigeria with corneas obtained from abroad, but such transplants are rarely done nowadays because donor corneas are not readily available.
“When the ESRBN was to be registered, we had to get permission from Governor of the Central Bank of Nigeria.I have gone to see the Comptroller of Prisons in Nigeria, to see what we can do to harvest corneas, because I have been told that when a prisoner is condemned to death and executed, the body belongs to the government and not the family.
“However, since 1999, after the military era has passed, no civilian governor has confirmed death penalties, so now there are now several prisoners waiting on death row because no Governor is ready to confirm their sentences.”
In a presentation themed: “Cornea Donation, A brighter World”, Chairman, Board of Trustees, of the Bank, Dr Olaseinde Akinsete, said with a blindness rate of 1 percent, 30 percent of the estimated 1.5 million Nigerians that are blind, have cornea problems and can benefit from cornea transplants.
Lamenting the non-effectiveness of the Cornea Grafting Decree 23 of 1973, Akinsete, who set up the ESRBN on his 75th birthday, said cultural beliefs, religion and taboos are major hindrances to the take off of the cornea donation culture in the country. He said even though corneal transplant is lawful in Nigeria under Decree No.23, titled Cornea Grafting Decree 1973, not many corneal grafting operations have been carried out in the country.
“As individuals, we can sign written permission for our corneas to be harvested at death, in order to restore the sight of a living blind person. Under the Decree, any person can, either by writing or orally in the presence of two or more witnesses, authorise the excision of his or her eyes after death. “The law stipulates that the person lawfully in custody of the body after death may, unless he has reason to believe that the request was subsequently withdrawn, authorise removal of eyes. Notwithstanding the promulgation of the above mentioned decree, not many corneal grafting operations were carried out in Nigeria.
“Among factors responsible for the appalling situation in which we find ourselves in regard to restoration of sight through corneal grafting are lack of donor of eyes and corneas, scarcity of Ophthalmologists interested in corneal grafting, remedial legislation, etc. The biggest challenge is the unbelief by the public that they should donate any part of their body after death and also that it is not possible to restore sight to a ‘blind’ person.”
Nigeria has about 1,170,000 blind people, based on a blindness rate of 0.78 percent. Cornea blindness is about 7.9 percent (92,430), that may benefit from corneal grafting. Between December 2015 and the second week in January 2015, four babies aged 8-11months with bilateral cornea infections, were referred to the Eye Bank.
As summed up by ESRBN Ambassador, Mrs. Dakore Akande, more Nigerians should resolve to pledge their corneas. “It is necessary to help somebody who is blind to see. To be able to donate your cornea is really a great legacy. I know it is tough, but we just have to be our brothers’ keeper and not just think about preserving ourselves,” she appealed.