Claremont woman undergoes ‘state of the art’ eye surgery in Groote Schuur, South Africa for the first time

The operation was performed on Ingrid Barge, 40, of Claremont. (Provided)

  • State-of-the-art eye surgery was performed at Groote Schuur.
  • An estimated 150 patients in the hospital need the procedure.
  • The procedure was a first for South African surgeons.

A Claremont woman who this week became the first patient in South Africa to have a corneal neurotisation procedure performed by doctors at Groote Schuur Hospital, says she is looking forward to regaining her independence.

“I can’t wait to get my independence back. It’s been a while since I’ve driven a car, and getting behind the wheel soon is exciting,” Ingrid Barge, 40, said after doctors finished medical intervention on Tuesday.

In September last year Barge suffered a stroke which affected his trigeminal nerve. She lost feeling in her right eye and later developed a condition called neurotrophic keratopathy.

Barge said his eye continued to irritate.

I am delighted to be the first patient to be operated on. I hope the results of the operation will be successful and bring hope to others who also need it.

The cutting-edge surgery, performed by Dr. Hamzah Mustak and Dr. Ben Moodie, requires a collaborative effort with an ophthalmologist and a plastic surgeon to restore the innervation of the cornea – the transparent covering of the eye that allows light to enter.

The cornea is rich in nerves and needs them to maintain a healthy surface. Still, there are several ways the innervation of the cornea can be damaged, Mustak said.

“If the innervation is damaged or absent, the cornea cannot maintain its integrity, resulting in erosion of the corneal surface and eventually scarring and loss of vision. There is a new surgical procedure described in which a nerve graft donor material is harvested to restore innervation to the cornea.”

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The nerve is taken from the patient’s leg, he adds.

During surgery, the graft is attached to the innervation of the opposite side, tunneled through the bridge of the nose, and then passed through the eyelid of the affected eye. The nerve is then carefully divided into several branches, and these are tucked into small pockets created at the edge of the cornea, Mustak explained.

New nerve branches will grow in the eye over the next six to 12 months.

This type of corneal damage is often difficult to treat and can lead to vision loss. Groote Schuur alone has about 150 patients requiring surgery.

The surgical team: Dr Martin Nejthardt, Nurse Sitho

The surgical team: Dr Martin Nejthardt, Nurse Sithole, Nurse Kraai, Dr Ben Moodie, Dr Hamzah Mustak, Dr Stephen Manyeruke

“I hope this will be the start so that more patients can have surgery at Groote Schuur Hospital,” Mustak said.

He traveled to Los Angeles to practice performing the operation.

“I’m super excited”

Moodie is a plastic and reconstructive surgeon based at Cintocare Hospital in Pretoria. He was mentored by Indiana University’s Chief of Plastic Surgery, Professor Greg Borschel, who is a pioneer in the field of corneal neurotization. He collaborated with Mustak and Groote Schuur’s ophthalmology department to learn the new technique.

Mustak said neurotrophic keratopathy means the eye has lost its normal protective sensation, as well as the ability to keep the cornea healthy and healthy.

“This condition leads to recurrent corneal defects and ulceration which heals with scar tissue and eventually leads to blindness.”

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Barge said the operation took about four hours and was absolutely painless.

“I’ve been taking it easy since being released from hospital and currently have an eye patch on so I don’t infect the eye and for healing to take place.”

She said no aftercare is needed, so she just needs to let her eye heal naturally.

“My eye was constantly red, I had no tears in my right eye, there was no sensation. Yes, I had vision but there was no sensation in my eye.

“I’m super excited that the surgery was a success,” she said.

Barge added that she had to keep the eye patch on for three months and should then have regained full sensation in her eye.

She had to quit her job as an au pair and stop driving due to inefficiency in her eye, adding that she was looking forward to getting back behind the wheel.

According to Mustak, the nerve will take between three and six months before it begins to fully function.

“The procedure is performed in a few specialist centers internationally. This surgery gives some hope to these patients by restoring the innervation needed to maintain a healthy cornea,” he said.


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