Two young people with a degenerative eye condition are among four patients to recently receive life-changing corneal transplants at Mediclinic Morningside. This was made possible by Mediclinic’s ongoing partnership with state hospitals to alleviate surgical backlogs. 

Living with vision problems

“I’ve had itchy eyes since I was four years old, and by the time I completed matric, my eyesight was really bad,” says Evy Mzimba, a young woman from Daveyton, Gauteng. Although she dreamed of furthering her studies, college remained out of Evy’s reach because of her failing vision. “I was unable to see clearly enough to read,” she explains. “I also couldn’t see at night and was so worried I would have to suffer with sore eyes and vision problems for the rest of my life.” 

Until recently Ntateko Matshinye was in a similar predicament. “At school I was always rubbing my eyes in class and had to wear glasses to be able to read the board,” he says. Now in his final year of IT and business systems studies, Ntateko was dismayed to learn he couldn’t see out of one eye. “I failed the vision test on my driver’s licence exam and was referred to Tambo Memorial Hospital in Boksburg,” he recalls. This is the state facility where both Evy and Ntateko were eventually diagnosed with keratoconus – a degenerative eye disease.  

Ntateko Matshinye is wheeled into the operating theatre.
Dr Lourens Coetzee, specialist ophthalmic surgeon at Mediclinic Morningside.
Keratoconus causes the cornea to form an irregular shape.

Understanding keratoconus

Tate Madlala, an optometrist and co-founder of the NGO Keratoconus Foundation South Africa, explains that over time, this condition causes the normally spherical cornea to thin and protrude, creating an irregular conical shape. “This irregularity of the cornea scatters the light entering the eye, significantly blurring vision,” he says.  

In Evy and Ntateko’s advanced stages of keratoconus, the cornea then becomes scarred and loses its transparency. “After a while, glasses no longer help and if left untreated, the patient becomes technically blind,” Madlala explains. He adds that the sole mission of the Keratoconus Foundation is to provide support to those living with the condition and to help state patients receive the necessary treatment. “While most patients can be treated with rigid contact lenses, up to 20% need surgery,” he says. “Corneal cross-linking can slow down the progression of the disease but often only a corneal graft (transplant) can restore vision.”  

Bob Govender, Industry Affairs Executive, Mediclinic Southern Africa.

“We consider this partnership a long-term commitment to patients in South Africa who suffer from keratoconus.”

– Bob Govender, Industry Affairs Executive, Mediclinic Southern Africa

Public and private partnership

Both Evy and Ntateko required a corneal transplant, says Bob Govender, Industry Affairs Executive: Mediclinic Southern Africa. However, state hospitals have long surgical waiting lists for this life-changing procedure. “The backlog exists not only in the Gauteng province, but throughout South Africa,” Govender adds. “To ease the burden, Mediclinic is partnering with the Keratoconus Foundation and other public entities to see how we can assist. We aim to perform a number of these corneal transplant surgeries in our theatres to help alleviate the backlog.” 

The diseased cornea is replaced with healthy donor tissue.
Dr Coetzee performed the corneal transplant procedures.
Evy Mzimba’s pre-op details are checked at Mediclinic Morningside.

In August this year, Dr Lourens Coetzee, a specialist ophthalmic surgeon at Mediclinic Morningside, performed corneal transplants on four state patients as part of this ongoing private-public partnership. Tissue was flown in from America and the surgery was conducted after hours at Mediclinic Morningside.  

What does a corneal transplant entail?

“This surgery replaces all or part of the patient’s diseased cornea with healthy donor cornea tissue,” Dr Coetzee says. “During deep anterior lamellar keratectomy (DALK) only the outer layer of the central part of the cornea is replaced with donor cornea. With this procedure there is virtually no graft rejection. During penetrating keratoplasty (PKP) the full thickness of the central part of the cornea is replaced with donor cornea and sutured in place.” 

The hour-long procedure is not painful, but the recovery process is long. “We leave the sutures in for a year and even once they’re removed, the journey doesn’t end there. We make sure the focus of the new cornea is appropriate for the eye and there are various ways of dealing with that, including implantable contact lenses or laser vision correction.” 

Tate Madlala, an optometrist and the co-founder of NGO Keratoconus Foundation South Africa.
Ntateko with bandaged eyes after his procedure.
Eagerly looking forward to a future of better eyesight.

Leaving vision problems behind

Ntateko can’t wait to have better eyesight in the future. “This surgery is going to help me so much because at the moment, when I work, the glare of the computer screen makes my eyes water,” he says. “The first thing I’m going to do when my bandage is off is to visit the Eye of Africa in Johannesburg South and enjoy the beautiful views.”

Govender assures that Mediclinic does not see these corneal transplant operations as one-offs. “We consider this partnership as a long-term commitment to patients in South Africa who suffer from keratoconus. We will broaden this initiative throughout the country and try to assist wherever there is a backlog for this type of surgery.” 

Tate Madlala with Evy Mzimba, who is now relieved to know her problems with sore eyes and poor vision are behind her.

Dr Coetzee emphasises that Mediclinic’s role is a collaborative one. “We are not trying to replace the vital services rendered by the state hospitals. This is a co-management collaboration. Mediclinic has the donated tissue and the facilities, but this doesn’t supersede Tambo Memorial Hospital’s invaluable service to the broader community.” 

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