Mr. Nagata’s two eyes had cataract extraction in the ‘70s. The old method of the surgery had caused left eye corneal endothelial decompensation. Then, Mr. Nagata had pentrating keratoplasty surgery in Japan. However, Mr. Nagata’s left eye began rejecting, led to diminution of vision, accompanied by eye irritation symptoms, pain, and symptoms gradually increased. Japanese doctors told him that he needed to do a penetrating keratoplasty surgery once again. But, he worried about the effect of surgery because the incidence of postoperative rejection would be higher. Therefore, he wanted to go abroad to see a doctor. After search and comparison in many ways, Mr. Nagata decided to see Dr. Li, Shaowei who was the president of Shanghai Aier Eye Hospital in China.
According to Dr. Li, Shaowei, Mr. Nagata's eye condition was very bad, his left eye did not only have corneal bullous, while the intraocular lens position was biased, the pupil was not round, no pouch. Under this eye condition, if did a penetrating keratoplasty surgery, the risks and rejection rate was very high. So, Dr, Li Shaowei considered to do an endothelial keratoplasty surgery to restore corneal transparency. This surgery, which performing an endothelial transplantation in eyes after penetrating corneal allograft rejection, was new and not been reported by media in the past. This was a new challenge for Dr. Li, Shaowei, who had performed 2000 successful corneal surgeries. Thus Dr. Li, Shaowei had made a sound response plan. In order to reduce the risk of surgery, it was decided to use advanced femtosecond laser to create a thin, smooth corneal endothelium and to minimize the incision.
In August 25, 2008, after full preoperative preparation, Dr. Li, Shaowei performed the endothelial keratoplasty surgery by using advanced femtosecond laser equipment for Mr. Nagata. The operation took only 30 minutes, but it was a great success! This success was not only attributed to the excellence of ingenuity and advanced medical skills, but also the trust of Mr. Nagata.
Today, Mr. Nagata came to Beijing Aier Intech Eye Hospital to look for Dr. Li, Shaowei.
Dr. Li, Shaowei made a detailed examination and analysis, Mr. Nagata’s right eye condition was more complex. It was difficult to determine whether to take out the artificial lens. If took out the artificial lens, it would increase the risk of damage of the eye. Because the old anterior chamber intraocular lens was a hard lens, must do a larger incision to be removed. The large incision would greatly increase the trauma to operative eye. In addition, after removal of artificial lens, postoperative vision would also be greatly affected. If Mr. Nagata wanted to get good eyesight after the surgery, he needed implant artificial lens once again. As mentioned before, Mr. Nagata had no pouch due to the previous cataract surgery, so it would become very difficult and dangerous to implant artificial lens again. Therefore, Dr. Li, Shaowei had decided to only do the corneal endothelium transplantation after consideration. Furthermore, Mr. Nagata’s corneal astigmatism was relatively high, so the operation would also adjust the corneal incision aiming to reduce the effect of postoperative astigmatism on eyesight. This operation plan was highly endorsed by Mr. Nagata.
The operation officially began at 2:30pm on April 18, 2017. The process was smooth during making the incision; injection of viscoelastic agent; deepen the anterior chamber; protection of lens; putting the corneal endothelial plant into anterior chamber; and a series of surgical procedures. However, the last step ran into trouble.