VIJAY NARAYNSINGH Professor of Surgery
A FEW DAYS ago, there were newspaper articles celebrating “historic” corneal transplant done by Dr Josh Ramkissoon at the San Fernando General Hospital (SFGH). In fact, one article stated it was “the first ever penetrating keratoplasty (cornea transplant) to be performed in TT’s public health system.”
While Dr Ramkissoon’s sight-restoring procedure is commendable, it should be placed in proper historical perspective. The first corneal transplant in Trinidad was in fact done at the Colonial Hospital, San Fernando, by Dr Lloyd John George, 57 years ago (in 1961). This is recorded in the book Surgery in Trinidad by Anthony de Verteuil.
After that landmark event, Dr George continued his excellent selfless work at that hospital, for several years. In 1968, he transplanted a cornea restoring sight to the older sister of one of today’s leading ophthalmologists.
During this same period, the 1960s, Dr Gordon Namsoo was doing corneal transplants at the Colonial Hospital, Port of Spain. His first case is most interesting. He sought and got permission from the authorities to harvest corneas from a prisoner who was to receive the death penalty by hanging. He went across to the Royal Goal on Frederick Street, PoS, and secured both eyes soon after the hanging. He used those corneas to restore sight to two of his patients. Both Drs Namsoo and George continued their work, doing several cases, after sourcing corneas from an eye bank in the UK.
In 1985, a surgical patient was dying on Ward 24, Port of Spain General Hospital (PoSGH). The surgeon in charge, Dr Jorsling, informed the ophthalmologists of the possibility of eye donation. Dr Deo Singh, ophthalmologist, drove to the home in Petit Bourg, San Juan, met the wife and daughter-in-law of the patient and obtained written consent to procure the eyes for transplant. Sight was restored to two patients by this initiative.
It was the first time that written permission was obtained from the family for organ donations in TT. After this initial effort, several corneal transplants were done both by Dr Singh and Dr Boysie Mahabir at the (PoSGH). Corneas were obtained from foreign eye banks but many were secured from cadavers at the Port of Spain mortuary.
On one occasion, a child flown in from Guyana had a successful corneal transplant at PoSGH. Also, in the mid 1980s, Dr Garth Taylor from Toronto, Canada, donated six corneas from their eye bank – all these were transplanted at the SFGH by Drs Taylor, Anirudh Mahabir and Dr Singh.
In 1986, a man died in the ICU at the SFGH. His wife agreed to organ donation and Dr Mahabir was able to restore sight to one his patients.
The first corneal transplant done at EWMSC was in 1990 by Dr Singh; the graft was donated from the US.
In 2008, a world authority on corneal transplant, Prof Alan Sugar from Michigan, USA, came to advise and assist our local transplant surgeons. Several corneal grafts were purchased from the Miami Eye Bank by Health Minister Raphael. Prof Sugar was so impressed at the surgery performed by our local surgeons that he said there was little need for his intervention.
In December 2013, the International Sight Restoration Eye Bank of Tampa, Florida, donated 20 corneas as their Christmas gift. It was called Seesons Gift of Sight. Drs Singh, Sonja Johnston and Rishi Sharma performed 20 successful corneal grafts at the Scarborough General Hospital, Sangre Grande County Hospital, PoSGH and the EWMSC. At the SFGH hospital they were assisted by Dr Vishwamitra Ramdath who performed two of the five cases done there.
As recently as 2015, three corneas were donated by the International Eye Bank. All were transplanted at the Scarborough General Hospital by Dr Singh and his team – with 100 per cent success.
All the cases enumerated above were done at our public hospitals at no cost to these patients. In every case, our ophthalmologists took the initiative to obtain the corneas from almost every available source. Moreover, in several cases, ophthalmologists went to all our major hospitals, including Tobago, to serve our patients, at no charge.
Their volunteerism goes beyond national borders. In October 2016, Drs Singh, Johnston and Sharma procured corneas from the Lions Eye Bank in Texas and journeyed to Guyana to restore sight to their patients – all at no charge.
Dr Singh’s team has done charity missions in eye surgery in Mexico, Ecuador, Jamaica and Africa. In Ghana, the effort went further in designing, funding and equipping a stand-alone eye clinic in a township called Pramso; this was done in conjunction with Dr Garth Taylor’s team from Canada.
In conclusion, I felt it necessary to give a brief overview of corneal transplantation in the public hospitals in TT since our media publicised the “first ever” ... “historic local transplant.” We have a very rich history of pioneering and voluntary work in ophthalmology that ought to be recognised and celebrated. It is in the context of this glorious history that the recent transplant should be regarded.