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Hospital Spotlight: Cornea transplant “greatest gift of all” for recipient

Posted Apr 25th, 2024

This is an opinion column by Niagara Health Communications Specialist Tiffany Mayer, originally published in the St. Catharines Standard, Niagara Falls Review and Welland Tribune.

Perry Wintle stands outside the Niagara Falls Hospital. He is a cornea transplant

Perry Wintle required a cornea transplant after a bacterial infection in his eye. The Niagara Falls man was grateful for the care he received from Niagara Health Ophthalmologist Dr. Chris McLaughlin and his team throughout the long treatment process. 

Perry Wintle knew his risk of eye infection was high when he became an extended-wear contact lens user.

Erring on the side of safety, the Niagara Falls man made a habit of changing his 30-day lenses every 25 days. So when he woke with an irritation in his left eye on his last day of a Caribbean vacation four years ago, and only 20 days into his current lens cycle, it struck him as odd but easily solvable.

Perry would just remove the contact lens. It was a decision that would dramatically impact his life for the next three years.

The itchy, scratchy feeling he woke with turned into outright pain when he removed the contact lens, and a layer of eye tissue that came with it. The day after returning home, “the pain was at a level I’d never experienced before. It was like someone stuck a cigar in my eye,” Perry said.

He also couldn’t see out of his left eye. A trip to the Niagara Falls Emergency Department led to Perry being connected with Niagara Health Ophthalmologist Dr. Chris McLaughlin, who determined that a bacterial infection had disintegrated Wintle’s cornea, and with it, the vision in his eye.

Fixing it would require a full cornea transplant, a procedure only able to happen because someone had registered to be an organ and tissue donor, and made their wishes known before they died.

April is BeADonor Month, an annual campaign when healthcare organizations, including Niagara Health and Trillium Gift of Life, band together to encourage discussion about organ and tissue donation, and encourage people to register as donors.

One organ donor can save up to eight lives and enhance as many as 75 more through the gift of tissue. And the cornea is one tissue that can usually be donated at any age.

“For two years, I was walking around very, very visually impaired. When I got the transplant, it was a gift to have my vision back.”

“With corneas, there aren’t always a lot of contraindications, so when the time comes, we might say unfortunately a person’s heart or lungs aren’t suitable for donation but their corneas might be,” Dr. McLaughlin said. “The other thing is, we have two corneas to donate.”

Getting to the point of Perry’s transplant took more than a year and a half of care by Dr. McLaughlin and his team. It also took incredible strength on Perry’s part.

“For two years, I was walking around very, very visually impaired,” Perry said. “When I got the transplant, it was a gift to have my vision back.”

The cornea is the clear, dome-shaped surface of the eye that provides most of the eye’s focusing power. With pre-existing vision issues in his right eye – Perry had a lazy eye and could see only peripherally – his left eye had enabled him to see clearly for most of his life.

Those early days of care, just as the world locked down for the COVID-19 pandemic, meant six weeks of near-daily visits with Dr. McLaughlin to monitor the infection and treat it with steroids.

The infection left scar tissue, impairing Perry’s vision, and making him a candidate for a full-thickness cornea transplant. Given his age, health and situation, the surgery had an 80-90 per cent chance of success, Dr. McLaughlin explained.

But time would still be needed to ensure the infection had passed and the eye was sterile before Perry would be ready for the transplant. Schedules would have to align for surgery, then another week or two of waiting for a donor cornea to become available, although emergency transplants can happen within 24 hours.

It would take another year after that for Perry to recover fully.

Meanwhile, Perry, a writer who had always looked to the bright side of life, fell on dark days.

Early on in his treatment, Perry sat in his darkened apartment, his eye excruciatingly sensitive light. He began using an eye patch to ease his discomfort. When he drove, he had to keep his head craned to one side in order see out of his right eye. He relied on his daughter, Cassandra, a registered nurse at Niagara Health, to take him to appointments. He also had to live with eye pain that lasted until his surgery.

“The waiting for surgery was a nightmare because the pain never went away,” Perry said.  

Depression set in. He started to worry about whether the transplant would be successful when the time came.

“I didn’t think it would take. If it doesn’t take, you don’t get a second chance,” he said. “The thought of going blind for the rest of your life, it messes with you.”

The mental health challenges that can come with waiting for a transplant aren’t uncommon, Dr. McLaughlin said. Some patients have to stop working because of the pain. After the transplant, recipients are limited in what they can do for the next couple of months because of the 16 evenly spaced stitches tied at precisely the right tension holding the cornea in place. Those same stitches can be removed only two or four at a time to shape the cornea “like a soccer ball” and prevent severe astigmatism that’s not easily corrected.

In Perry’s case, it took six months before all his stitches were removed.

Recipients can’t exercise or lift heavy loads. They may be sensitive to light, too.

“With corneal transplants, there’s a lot that goes with it,” Dr. McLaughlin said. “It definitely has an impact on patients for sure.”

But so, too, did the moment when Perry first opened his eyes after delicate surgery at the Welland Hospital under McLaughlin’s steady and gentle hand.

“As soon as the cornea was in and stitched in, I could see. It was blurry but it was incredible I could do that,” he recalled.

Surgery for cataracts, exacerbated by the steroid drops he had to take before and after surgery, was the last step in regaining his eyesight. Perry chooses to wear only glasses now.

He’s also forever grateful to the care he received from Dr. McLaughlin – “He’s brilliant,” he said – and to the person who donated their corneas after dying so Perry, who is also registered as a donor, could live life to the fullest again.

“I feel absolutely wonderful every day. It’s the first thought in the morning – that I can see,” he said. “It’s the greatest gift of all.”

Niagara Health System