2 January 2007
They turned to Singapore when their eyesight failed        

Canadian teen with rare disorder regains eyesight after tricky operation

The Canadian boy, then 13, had the dreaded Stevens-Johnson syndrome, a potentially fatal allergy that hits children and young adults. He spent 40 days under intensive care at the Children’s Hospital in Vancouver.

Almost 70 per cent of his body was covered with burns. His mother almost freaked out when doctors said he had similar blisters inside his body. He recovered but his left eye became infected last year.

In spite of four operations, his cornea melted away and he lost the sight in that eye. Then, in March last year, a tiny scratch on the surface of his right eye would not heal.

Desperate, his parents took him to several eye specialists in Vancouver but none had seen anything like that.

They then turned to an American specialist who tried healing it with amniotic membrane taken from a placenta, with blood serum therapy, and with an experimental epithelial growth factor.

The problem not only persisted, but the infection also created a 4mm hole in the cornea. By then, Brent could see only around that hole.

The only option left was a corneal transplant, but there was a 90 per cent risk of rejection in a Stevens-Johnson patient. That was when Brent's father, Mr Phil Chapman, heard of Professor Donald Tan, deputy director of the Singapore National Eye Centre.

The family went to Las Vegas to meet Prof Tan when he was there for an eye conference in November. They also met several other specialists there for second opinions, and decided that the best chance for Brent, now 15, was to come to Singapore.

In an operation last month, Prof Tan replaced the front part of the cornea, leaving the thin bottom layer with the hole in it.

This endothelial layer is thicker in children and will spread out to cover the hole eventually, Prof Tan said.

For Brent, the past two years has been a roller-coaster of 'some good days and some pretty horrible and painful days'.

Able to see again after the transplant, Brent said: 'After losing my left eye, blindness became a reality. I really don’t know if I could have accepted it.'

Thai with mysterious eye infection sought help in Thailand, US before finding successful treatment here

A trip to India immediately after did not help, and by the time Mr Kitti Anansongvit, 47, returned to Bangkok, his eye was red and infected.

The businessman saw several ophthalmologists in Bangkok but they could not identify the problem.

He then sought treatment in the United States where he spent six weeks. Under the care of Associate Professor Kenneth Goin of the University of Iowa Hospitals, his infection improved.

But by then, most of his sight in the left eye was gone.

'It was very tiring using just one eye. I tried driving, but I couldn't judge the speed of oncoming cars. I also had trouble crossing the street,' Mr Kitti recalled.

Two months after his return to Bangkok, the infection flared up again.

Prof Goin suggested that he see Professor Donald Tan, deputy director of the Singapore National Eye Centre, for a transplant.

By the time he got to Singapore last month, his left eye was so badly infected he could see no more than 30cm in front of him.

The Singapore National Eye Centre too could not identify the organism at the root of the problem. By then, the infection had spread to almost the entire cornea.

Last week, Prof Tan decided to go ahead with the transplant. He removed all the upper part of the infected cornea, leaving only the thin endothelial layer which was still clear of infection. With this layer intact, there is practically no risk of rejection.

But the infection could recur. Prof Tan said it was all a 'numbers game'. With the transplant, much of the bacteria was destroyed or removed. The hope now is that a course of antibiotics will kill off any remaining bugs.