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'I was trying not to cry'
Implant lets blind man see wife for 1st time in 5 years
February 11, 2007
BY JIM RITTER Health Reporter

Tuesday morning, like every other morning for the last five years, George Setinc woke up a blind man.

But Tuesday afternoon, he suddenly could see again.

	George Setinc, his wife Linda and Dr. Azar.

George Setinc can now see after receiving an artificial cornea operation performed by the team of doctors Jose de la Cruz and Dimitri Azar (right).
(Al Podgorski/Sun-Times)

That morning, doctors at the University of Illinois Medical Center at Chicago implanted an artificial cornea in Setinc's left eye.

Four hours after the surgery, the patch came off. Dr. Dimitri Azar asked Setinc's wife of 41 years, Linda, to put up some fingers.

How many do you see, Setinc was asked.

"Five," Setinc answered.

And he was correct.

"As far as I'm concerned," Linda said, "this is a miracle. You don't expect someone who is blind to see after all these years."

It was the moment they had been praying for for so long.

"I was trying not to cry," she recalled. "I was shaking. It was so joyous."

The cornea is the transparent, dome-shaped surface of the eye that does much of the eye's focusing. Patients can lose vision if corneas are scarred, clouded over, swollen or otherwise damaged.

The conventional treatment is to transplant a cornea from a deceased donor. Since there generally is an adequate supply of donor corneas, patients typically don't have to wait for transplants.

There are about 30,000 cornea transplants in the United States each year. The surgery usually succeeds in restoring sight. In some patients, however, transplanted corneas eventually fail because the body rejects them or for other reasons. About 13 percent of cornea transplants are done on patients in which earlier transplants have failed.

Artificial corneas, made of clear plastic, are generally intended for patients who have failed two previous transplants. They also are used in certain patients, such as Setinc, who don't qualify for conventional cornea transplants.

Part plastic, part donated

Setinc has Stevens-Johnson syndrome, a condition in which the immune system attacks healthy tissue, including the cornea. The condition made Setinc ineligible for a conventional cornea transplant.

Setinc, 61, has had vision problems for much of his life. By 1975, he was legally blind. Although he still had some sight, he had to quit his job repossessing cars.

Over the years, Setinc's vision continued to deteriorate. Five years ago, he went blind. He could tell whether the lights were on but couldn't see anything.

People had to tell him what his grandchildren looked like. He missed watching TV, especially boxing and "Walker, Texas Ranger." Setinc, who lives in Downstate Savannah, took a blind rehab program at Hines VA Hospital. He learned how to cook, how to work with tools, how to navigate with a cane.

Setinc's new cornea is part plastic, part donated tissue. The plastic part was clamped into the center of a cornea from a deceased donor. This new cornea then was sutured into Setinc's eye.

Improvements

One of the first things Setinc saw when the patch came off was Linda's face. "I saw a woman I haven't seen in five years," he said.

"She looked good."

Setinc now has 20/100 vision in his left eye, meaning he can see at 20 feet what a person with normal vision can see at 100 feet. His vision will probably continue to improve, said Dr. Jose de la Cruz, one of his surgeons.

Patients are at risk for infections that could destroy their new corneas. The risk is especially high in those with Stevens-Johnson syndrome. Setinc must take antibiotic eyedrops every day.

The artificial cornea was developed over the last 40 years by Dr. Claes Dohlman of Harvard Medical School. (Azar, who did Setinc's surgery, was a colleague of Dohlman's before coming to UIC.)

Dohlman said early attempts failed miserably, but improvements have been made. Of 173 artificial corneas Dohlman and a colleague have implanted in the last three years, only two have failed.

Dohlman said about 1,200 patients worldwide have received his artificial cornea, called the Boston Keratoprosthesis. About 80 surgeons, mostly in the United States, are trained to implant it. A second artificial cornea on the market is called AlphaCor.

jritter@suntimes.com

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