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Woman recovers sight after historic stem cells surgery

A partially blind woman has regained her sight after receiving Kenya’s first-ever stem cell transplant from a placenta.

Jane Muthoni lost her sight completely in the left eye in 2013 after a laboratory accident in school. Her right eye is normal.

Late January, she became the first Kenyan eye patient to receive a stem cell transplant at the Laser Eye Centre in Nairobi. The surgery was performed a team of four specialists led by Dr Mukesh Joshi.

A review carried out on Saturday shows the left eye has healed, slowly restoring sight to the 23-year-old woman.

“We transplanted stem cells from the opposite eye to the damaged eye, a procedure that requires a lot of minute details,” Nairobi-based ophthalmologist Joshi said.

Millions of stem cells are found at the junction of the white and black parts of the eye.

“Once the stem cells are taken from the opposite eye, they will not stick to the cornea, so a special membrane, known as the amniotic membrane, is derived from the placenta imported from the USA,” he said.

This membrane is applied with special glue so it can stick to the damaged cornea. “Stem cells gradually start repopulating and giving nutrition to the superficial layer of the cornea since the cornea does not have a blood supply.

“With improved nutrition, the cornea starts becoming clear once the newly transplanted stem cells get repopulated,” Mukesh said.

Scan images show Muthoni’s eyes are now less cloudy and streaks of veins that ran through the cornea have disappeared.

The function of the stem cells is to give nutrition to the cornea to enable it to maintain its clarity since the cornea does not have a blood supply. The cornea is the first transparent part of the eye, through which light passes.

Due to injuries, like chemical accidents or infections, the cells get damaged, making the cornea cloudy and blood vessels start to run on it.

Muthoni had normal eyesight until the high school laboratory accident damaged her left eye.

Corneal wound healing is a complex process that occurs in response to various eye injuries and surgery. Delayed or incomplete healing is a significant clinical concern.

The Kenyan case presents evidence of the role of stem cells in corneal wound healing.

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How a placenta helped restore my eyesight

For 23-year-old Susan Muthoni, the placenta recently restored sight in her right eye, which she lost after a chemistry experiment gone wrong in secondary school five years ago. In January, she got stem cell eye surgery at the Laser Eye Clinic in Nairobi. Through a transparent, perforated plastic shield that is strapped on her right eye, a white membrane that stretches on the eye is visible. An amniotic membrane, from the placenta, that would help her eye heal faster without leaving scars was used. The amniotic membrane ensures regeneration of stem cells in the affected eye once the stem cells are transplanted. CHEMICAL BURN “Corneal stem cells offer nutrients to the cornea, the window of the eye through which rays of light pass. Stem cells form the junction of the white and black part of the cornea. “Damage causes the cornea to become cloudy. To reverse the damage, stem cells can be transplanted,” said Dr Mukesh Joshi, the ophthalmologist who performed the surgery. The chemical burn damaged Ms Muthoni’s cornea cells, and turned off the light. “Amniotic membrane is used in eye surgery for surface reconstructive surgery. The membrane prevents the formation of scar tissue. The scars affect proper movement of the eyelids and movement of tears across the eye,” said Dr Joshi. If the patient’s other eye is healthy, stem cells can be removed from it and transplanted into the affected eye. There are thousands of stem cells that feed into the cornea, but about two per cent are needed for the transplant. In case both eyes are damaged, the stem cells are acquired from the eye of relative or family member based on tissue type match. The cells are then multiplied on the amniotic membrane, then glued on to the eye with a special glue that does not affect the eyelids. The area is then covered by a contact lens, and a shield is placed to protect the eye. The stem cells should start growing back in six weeks. The membrane dissolves and the patient’s cornea starts clearing. The amniotic membrane used on Muthoni was imported from the United States, where placentas are collected from consenting mothers, then preserved at appropriate temperatures. FUTURE USE In some countries, transport of live amniotic membrane is not permitted, so it is dried for future use, and later activated to create a conducive environment for transplanted eye stem cells to grow. “From 600 cells, you will have 20,000 cells in six months, to give the cornea nutrition, which it was deprived off when it was cloudy,” said Dr Joshi. Stem cell surgery is performed on patients with severe infections that affect the cornea, those whose corneal stem cells have suffered burns, or people suffering from an infection affecting the mucus membrane. Transplants can also be done from donated eyes, and though there is an eye bank in Kenya, there are not enough donations. “We need a specialised laboratory to grow stem cells. “Unlike the eye bank where you need to collect the eye from someone who is dead, stem cells can be collected from live donors and grown, then used to treat partial Read more How a placenta helped restore my eyesight

Kenyan woman blinded at 17 regains eyesight using stem cell technology

At the age of 17, Susan Muthoni had normal 20/20 vision. Like most people with perfect eyesight, the then high school student never imagined she would one day have a problem. In 2013, less than a week before she sat her KCSE exams, she had an accident in the laboratory, one that involved chemicals spilling into her eyes, burning them severely. Special glasses She was able to write her exams using special eyesight-enhancing glasses, which boosted the vision of her left eye. While her left eye was able to see partially, her right eye went completely blind. “I went to Kikuyu Eye Hospital but the doctors said there was not much they could do except give me the enhancing glasses,” Muthoni told The Standard during an interview a day after she underwent a groundbreaking surgery last week. Now aged 23, Muthoni said the loss of her sight greatly diminished her ability to properly write the exams and consequently affected her performance. Even in the years after the accident, as a purchasing student at the University of Nairobi, Muthoni had to sit at the front of the class. But even then, she could only see blurred images. Muthoni’s quest to regain her sight has been complicated, expensive and agonising. Just when she had resolved to travel to India, her last resort, a family friend recommended that she try Laser Eye Centre, a clinic in Westlands, Nairobi. The odds changed for Muthoni forever. Not only will she be able to see again, but with the procedure that restored her sight, the young woman made history as the first recipient of a stem cell transplant of the eye, not just in Kenya but East Africa. The stem cell transplant conducted last Monday involved a team of four specialists led by Mukesh Joshi and lasted just under three hours. “It was smooth but technically challenging,” Dr Joshi admitted. According to the specialist, Muthoni’s blindness was a result of chemical injury to the eye. The doctor further said that not many treatments were available for Muthoni’s condition. The other option, Joshi said, would have been a corneal implant, which would most likely have been ineffective at fully restoring her sight. “For a cornea with stem cell deficiency, a corneal transplant will fail. A stem cell transplant, on the other hand, increases the chances of recovery of the cornea as stem cells will start giving nutrition to the superficial layer of the cornea since the cornea does not have blood supply. With improved nutrition, the cornea will start becoming clear once the new transplanted stem cells start repopulating,” said Joshi. He explained the procedure of a stem cell transplant of the eye. “We took healthy stem cells from Muthoni’s left eye and transplanted them into the right one. “Stem cell transplant has been in vogue in the past few years. It requires a very specialised membrane, known as the amniotic membrane, which is found in the placenta. This membrane is required to cover the damaged cornea to allow stem cells to grow, as stem cells will not grow on the cornea on its Read more Kenyan woman blinded at 17 regains eyesight using stem cell technology

Liberated from a life of glasses: How laser surgery changes lives

The envoy had travelled there for the traditional Lasik surgery so he could see without glasses or contacts lens. But ophthalmologists said his cornea was too thin and nothing could be done. His situation was salvaged in Nairobi, which is now becoming a centre of advanced medical practice. “I met Dr Joshi and was told about the new technology, C-ten, no touch, no cut,” he says. The envoy completed the necessary assessments, after which Dr Joshi Mukesh informed him he was a perfect candidate for C-ten. Dr Joshi is a leading ophthalmologist, who runs Africa’s only C-ten services at his clinic at the Sarit Centre in Nairobi. “After my laser correction, I have got perfect eyesight; I can see better than I could with my contact lenses,” he said in a testimonial.   WOES OF GLASS WEARERS Pitteloud’s frustrations with sight would probably only be understood by people who wear glasses. While wearing glasses can be fashionable, they are first and foremost medical devices. That is why, despite going through most of their day wearing them, many glass wearers picture themselves as having perfect 20/20 vision when constructing their self-image in their mind. When taking a group photo, some even take their glasses off, because their self-perception is as a non-glass wearer. Being forced to carry around a flimsy piece of vital equipment changes your life. “Literally your world is framed and it’s narrower,” says Imre Makaka, 25-year-old third-year Bcom student at the University of Nairobi. He is shortsighted and was on glasses for 20 years. “If you need to look to the side, you have to turn your whole head, rather than turning the eye itself, like other people. He says there is no spontaneity in life. “You cannot take part in a fight or random game with your glasses on. You’re also cautious during shoulder-bump greeting. It makes people think you’re weak.” Makaka was liberated from glasses after a C-ten laser surgery two weeks ago. “I was told about C-ten by my mother, then I checked the credentials of the doctor. Of course it was more costly, but I used to spend close to Sh50,000 every month for check-ups and glasses,” he says. More Kenyans who can afford are now making this step. HOW IT WORKS Dr Joshi has been a consultant ophthalmologist for 25 years, and is easily one of the most experienced and respected laser eye surgeons on the continent. The surgery took 30 seconds for each eye. Dr Joshi explains that C-ten uses the latest technology, where there is no contact with the patient’s eye. “The procedure is the safest and fastest treatment available with minimal recovery time,” he says. “It is very important for you to come in for an assessment, as not everyone who wears glasses or contact lenses is a suitable candidate for Laser Vision Correction.” Makaka’s assessment took about an hour. He placed his chin on the front end of a Modern Tomography Precisio machine, which provides a detailed, three-dimensional mapping of corneal inner and outer surface. The machine takes about 39,000 spots of the eye and defines the real shape of the cornea’s anterior and Read more Liberated from a life of glasses: How laser surgery changes lives

Rotary International Significant Achievement Award

For the first time in its 85 year history, the Rotary Club of Nairobi and Dr. Mukesh Joshi were awarded with the Rotary International Significant Achievement Award in recognition of their Kenya Rural Blindness Eradication project. This is the highest service award that can be awarded to any Rotary Club. This award was presented to ... Read more Rotary International Significant Achievement Award

Dr. Mukesh Joshi receives Mahatma Gandhi Award at House of Lords

Dr. Mukesh Joshi was honored with the Mahatma Gandhi Award on the 12th October 2012. He was presented this award at the House of Lords in the Houses of Parliament (UK) by her Right Honorable Baroness Sandip Verma (Minister of Energy and Climate Change – UK) on behalf of the NRI Welfare Society of India. Read more Dr. Mukesh Joshi receives Mahatma Gandhi Award at House of Lords