Ophthalmologists at Dr. Agarwal’s Eye Hospital in Chennai performed a complex, first-of-its-kind surgical intervention that restored functional vision to a 44-year-old gynecologist from Mumbai who had been blind due to severe eye disease and complications from prior surgeries.
The patient had suffered from progressive vision loss over more than a decade, primarily due to severe glaucoma, a group of eye conditions characterized by optic nerve damage often associated with high intraocular pressure and multiple refractory intraocular pathologies that had not responded to earlier treatments.
Despite several prior surgical attempts, her sight deteriorated until she became completely blind in one eye and had only light perception in the other. Upon presentation at the Chennai centre, doctors identified a malpositioned artificial intraocular lens (IOL) pressing against the iris and cornea, distorting the eye’s anatomy and contributing to ocular fusion of anterior structures.
To address this complex case, the surgical team used a novel combined approach in a single surgical session:
Removal of the faulty IOL
Advanced 5F-ISHF intraocular lens implantation, a suture-free, flapped intraocular lens fixation technique developed by ophthalmologists at Dr Agarwal’s Eye Hospital
Optical penetrating keratoplasty (OPK), a full-thickness corneal transplant
Structural reconstruction of damaged ocular anatomy
Pupilloplasty, surgical repair and reconstruction of the pupil
This integrated method not only removed the problematic lens but also restored the cornea and other critical eye structures, creating conditions for improved vision.
The 5F-ISHF technique, which enables secure, stitch-free intraocular lens fixation by tucking the lens within the eye’s structural layers is designed for complex cases where traditional fixation methods may not be feasible.
Immediately after surgery, the patient regained functional vision measured at 6/24 in her left eye. Surgeons noted that further improvements are likely as healing continues.
According to hospital specialists, simply addressing one aspect of the problem, such as replacing the lens or performing a corneal transplant alone would not have restored functional vision. The success of this case stemmed from the combined surgical expertise and coordinated approach tailored to correct multiple anatomical issues simultaneously.
See also: Documentary Reveals Hidden Dangers of Cosmetic Iris Implants
Glaucoma is often caused by increased pressure within the eye that damages the optic nerve, which can lead to progressive and irreversible vision loss if untreated. Patients with complex glaucoma may also develop complications that interfere with normal ocular structure and function, especially after multiple surgeries.
The surgery was led by Dr. Soosan Jacob, Director and Chief of Dr Agarwal’s Refractive and Cornea Foundation, who developed the 5F-ISHF technique. The coordinated team approach underlined the hospital’s capability in managing highly complex ophthalmic cases involving both refractive and structural challenges.
Dr Ashvin Agarwal, Chief Clinical Officer and Senior Ophthalmologist at the hospital, emphasised that the integrated, multifaceted surgical approach was crucial to restoring functional vision in a case that had resisted treatment for many years.
This case highlights advancements in surgical techniques for managing refractory eye pathologies associated with glaucoma and complicated intraocular conditions. It may inform future strategies for complex ocular reconstruction and intraocular lens implantation, especially when traditional methods fail.
(Rh)
