Stem cell transplant gives him gift of sight
Deepa Suryanarayan
Friday, February 13, 2009 2:58 IST
Mumbai:
Two-year-old Pratik Patil does not know it yet, but he has just been
bestowed with
the gift of sight. Thanks to a new procedure performed for the first
time in Mumbai,
Pratik may get back up to 70% of the vision in his left eye in the
next six months.
Salman Ansari / DNA
In layman's terms, the procedure -- limbal stem cell transfer --
involved taking
healthy stem cells from Pratik's unaffected eye, culturing (growing)
them in a laboratory,
and then transferring them to the affected eye.
The diagnosis:
Pratik's problems started a year ago, when he started passing blood
in his stool.
"I took him to the district hospital, and then to Nair Hospital,
where several tests
including CT scan, biopsy etc later, he was diagnosed with TB of the
intestine,"
said Arun Babu Patil, 32, Pratik's father. A farmer from Kadar
village near Kolhapur,
Patil could not afford the treatment for his son, but took him to
several hospitals
in the city. "He suffered from severe bleeding and about a year ago,
we noticed a
boil around his left eye," recalled Patil.
"When he was brought to Bombay Hospital, Pratik's cornea was clouded,
his eyelids
were almost glued shut. He was suffering from xerosis (severe dryness
in the eyes)
and limbal stem cell deficiency," said Dr Sonia Nankani, consulting
eye surgeon,
Bombay Hospital. This condition is seen among patients suffering from
Vitamin A deficiency,
Steven Johnson's syndrome, allergic reaction, trauma to the eyes,
heat burns or chemical
injuries. However, according to Dr Nankani, Pratik's history of
severe malnutrition
and intestinal TB and severe bleeding may have contributed to his condition.
"The cornea is like a watch glass. When its surface is not smooth, it
is unable to
refract light properly, impacting the person's ability to see," said
Dr Nankani.
The procedure:
Between the cornea and the sclera, (the eyeball's white outer
coating), is the limbus,
where 'mother cells' reside, which are capable of producing corneal
epithelial cells.
On December 31, Dr Nankani performed a biopsy and removed a portion
of the limbus
stem cells from Pratik's unaffected right eye. "The limbal stem cells
are taken from
the healthy eye of the patient, if one exists, or from a donor --
usually a sibling
or a parent," she explained.
The cells were then sent to a city-based laboratory, where they were
cultured. "The
cells are placed on the amniotic membrane (from a donor), where they
are allowed
to multiply for 14 to 21 days," explained Dr Nankani.
Then on January 15, in a 45-minute procedure, the newly cultured stem
cells along
with the amniotic membrane were transferred to Pratik's affected eye.
Research over
the past 10 years, has established the high success rate of growing
the new cells
from transplanted limbal stem cells.
"But even if it is not completely successful, the limbal stem cell
transplant will
buy us the time to perform corneal transplant after six months," said Nankani.
The good news
While certain medical institutes like LV Prasad Institute, Hyderabad,
AIIMS, Delhi,
Arvind Netralaya etc have had the infrastructure to culture limbus
stem cells for
several years, Mumbai has now got a laboratory which will allow
surgeons like Dr
Nankani access to FDA-approved commercially available cultivated
limbus stem cells.
The procedure, of course, comes at a cost: Rs 44,000.
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