Three years – that is how long Johanne Provost was without her vision. An auto-immune condition caused her body to attack the stem cells around her cornea, allowing blood vessels to snake their way across this front covering of her eye, which would normally be transparent. This process ultimately led to a build up of scar tissue, which caused her to gradually lose her vision.
Searching for answers
For months, Johanne had been seeking answers – suggested treatments for dry eyes, scleral patches and doctors shrugging their shoulders. More typically presenting as a skin condition, her eye disease evaded diagnosis. The ophthalmologist in her home province of Quebec began a treatment, intravenous immunoglobulin (IVIG), used only rarely for those with autoimmune diseases, with the hopes of reducing the inflammation in her eye.
While the IVIG monthly infusions helped to improve the inflammation in her eye, Johanne would need an ocular stem cell transplant to repair the damage and restore her vision. These stem cells would usually be transferred from the patient’s other healthy eye – however, Johanne had no usable stem cells remaining, as both eyes had been affected. Little did she know that her doctor in Quebec had been consulting with Dr. Clara Chan, a UHN cornea surgeon and researcher in corneal diseases and therapies.
“A case like Johanne’s is extremely rare. I have only seen a handful of patients with this condition in the last 15 years,” says Dr. Chan.
A never done before solution
To acquire usable stem cells, Dr. Chan used the cornea from a deceased donor. UHN is the only institution in Canada which offers ocular stem cell transplants from non-living donors. To undertake this surgery, Dr. Chan collaborated with a dream team of patient care coordinators and transplant specialists. This included, UHN nephrologist and transplant physician, Dr. Joseph Kim, who provided guidance on a regimen of oral immunosuppressants to prepare Johanne for the surgery.
Following her surgery and recovery period, Johanne opened her eyes to see her children, now teenagers, and her husband, all three years older than when she had last seen them. With her eyesight restored, Johanne is now able to continue from where she left off before her vision started to disappear. “It gave me back my life – my independence, my liberty,” she said.
When TeamUHN comes together, anything is possible. UHNITED in the face of Johanne’s unique condition, Drs. Chan and Kim, and their teams, were able to do what has never been done.
No one ever changed the world on their own but when the bright minds at UHN work together with donors we can redefine the world of health care together.
