NOTE WORTHY

“Iris Repair” continues from page 23

They altered their route and headed to UI Hospitals & Clinics where within hours surgery was done first to repair the injury to the eye and remove the steel. Surgeons discovered the steel had narrowly missed the optic nerve, which meant Molyneux could possibly regain vision in that eye. First, though, the wound would need to heal, which meant his iris would remain damaged, compromising his vision.

Living with light sensitivity

The iris is the colored part of the eye surrounding the pupil, the small black opening that lets light in. The pupil is controlled by the muscles in the iris — when the pupil is wider more light gets in; when it’s smaller, less light is allowed in. The eye needs an aperture — a pupil — to block most of the light to which the eye is exposed. Without the iris, too much light comes in. When there is damage to the iris, or there is no iris, the pupil can’t function as it should and too much light is allowed through the eye.

Molyneux’s damaged iris was barely visible, and his pupil was very large.

“A good analogy is like trying to have a conversation in a loud coffee shop,” Sales explains, “there’s just too much noise. The same is true of light – when there’s too much ‘noise’ vision is poor and there is light sensitivity.”

With Humanoptics the artificial iris looks real, unlike previous models that appeared almost robotic. The Humanoptics model is also flexible, allowing it to pass through a much smaller incision and allow for faster healing.

For the patient, Sales says, the biggest benefit is being able to walk outside without the glare of high-intensity light.

‘I can do a lot more’

In the year that passed between Molyneux’s initial repair surgery and getting his iris implant, he tried everything to keep the light out of his eye. He used patches, towels, bandages, and more, to no avail. He had to stop working with his nephews because he couldn’t be outside. Having lost his depth perception and his innate sense of level, operating a bulldozer and walking on uneven terrain also was difficult.

Molyneux received his iris implant in September 2022. He noticed an immediate difference.

“Since the surgery, I can now be out in daylight without dark glasses and that eye doesn’t bother me any more than the other eye,” he says. “On a scale of 1 to 10, my vision before the surgery was a 1 or 2. Now it’s probably a 6 or 7, and we can get it better with some glasses.”

His vision is better, too. Before surgery he said he could see a difference between light and dark and could make out shapes. Now, he says, he can read and write with ease, and watch his grandchildren play. Walking, working, operating equipment, and even relaxing have all improved significantly.

“I’m not going to tell you it’s perfect, but I went through a year of not being able to see out of that eye, I learned to walk with one eye open,” he says. “And now I can see. I have peripheral vision. I can do a lot more than I could before.”

That’s the outcome Sales was hoping for.

“This is one of the most gratifying surgeries I get to do,” he says. “Until you put in a prosthetic, these people are really sensitive to light, they can’t be outside on a bright day. And then you do the surgery and take the patch off the next day and they’re amazed, it’s a whole lot better. And it really is amazing.”

Sales acknowledges he would never have been able to perform Molyneux’s surgery had it not been for the ophthalmologists at UI Hospitals & Clinics who came before him. Thomas Oetting, MD, MS, and A. Tim Johnson, MD PhD, were involved in clinical trials for earlier iris prosthetic devices.

“They helped pave the way,” says Sales. “That’s one of the great parts of working at an academic medical center; we can provide patients with access to the latest advances in research and technology that can make a meaningful difference in their quality of life.”

By Molly Rossiter