New eye surgery offers fresh start

Ingrid Barge was the first to undergo a new eye surgery at Groote Schuur Hospital.

A Claremont woman – who was the first in South Africa to undergo a new, cutting-edge corneal surgery – says she is not only happy to have her quality of life improved but also to get her life back.

Ingrid Barge, 40, lost all sensation in the right side of her face, including her eye, after suffering a stroke in September. She was the first patient to receive the groundbreaking corneal neurotisation procedure at Groote Schuur Hospital, on Tuesday May 3.

The surgery, performed by Dr Hamzah Mustak – who received training in Los Angeles and Dr Ben Moodie, required a collaborative effort with an ophthalmologist, a specialist doctor, and a plastic surgeon.

In early September, Ms Barge experienced extreme dizziness to the point where she thought she was going to faint or throw up. It progressed rapidly from there to actual vomiting, being unable to stand or walk and one side of her face going numb.

“I was taken to a nearby Medicross who referred me to Groote Schuur for an MRI. I was taken to the emergency unit and the MRI confirmed that I had a lateral medullary stroke,” she said.

Ms Barge said her right eye had vision but no blink reflex or tear production. She eventually had to resign from her work as she could not drive or see properly.

“I kept getting micro abrasions on my eye from being unable to feel if something was in my eye or irritating my eye. Also, because there were no tears, I had to constantly add drops or ointment to lubricate the eye. I had to resign.I was unemployed and very depressed about the prospect of eventually possibly losing vision in that eye due to scar build-up,” she said.

Dr Mustak said there were several pathologies that could damage the sensory nerve supply to the cornea. The cornea, he said, was one of the most richly innervated tissues in the body and relied on this nerve supply to maintain a healthy corneal surface.

“If the nerve supply is damaged or absent, the cornea cannot maintain its integrity resulting in erosion of the corneal surface and eventually scarring and visual loss. There is a novel surgery described whereby a donor nerve graft is harvested to restore the innervation of the cornea. The graft is attached into the nerve supply of the opposite side, tunnelled across the bridge of the nose, and then passed through the eyelid of the affected eye. The nerve is then carefully divided into several branches which are then tucked into little pockets created at the edge of the cornea,” he said.

Speaking post surgery, Ms Barge said she did not fully understand the enormity of the surgery, but was willing to try anything to get back to a “normal” life. She said she had been taking it easy since the surgery and had only experienced a mild headache, which she said was nothing compared to the constant pain from the effects of the stroke.

“I am so grateful to Groote Schuur Hospital for firstly saving my life and then saving my quality of life. The doctors and staff are amazing, and I am so thankful that we have such a fantastic hospital in our beautiful city,” she said.

Dr Mustak said the nerve would take some time to start working, usually between three to six months. He said the hospital had about 150 patients who needed this surgery and he hoped this would be the start for more patients to be able to get the surgery done there.

Groote Schuur Hospital’s surgery team, from left, are Dr Martin Nejthardt, nurses Juliet Sithole and Poilsa Faith Kraai, Dr Ben Moodie, Dr Hamzah Mustak and Dr Stephen Manyeruke.