Islamabad: In a landmark achievement in eye care, surgeons at Shifa International Hospital Islamabad have successfully restored vision in a patient suffering from a severe, sight threatening eye infection following glaucoma surgery, performing what specialists describe as a rare and highly complex combined corneal and retinal surgery in Pakistan.
The procedure was jointly performed by Prof. Dr. Amer Awan and Prof. Dr. Farooq Afzal, Consultant Ophthalmologists at Shifa International Hospital, who managed to salvage the patient’s eye despite extensive infection and multiple complications.
According to eye surgeons, the patient developed bleb related endophthalmitis, a rare but highly aggressive infection that can occur after glaucoma surgery. The condition affects both the front and back portions of the eye and can rapidly lead to irreversible blindness if not treated urgently.
The patient had initially undergone treatment at another facility, where surgeons attempted to control the infection by washing the front part of the eye and removing the intraocular lens implant. However, the infection continued to worsen, leaving the eye critically inflamed while the cornea became severely opaque, making it almost impossible to visualise the internal structures of the eye.
“When the patient reached us, the infection had involved the entire eye, and visibility was extremely limited due to corneal opacity,” Prof. Dr. Amer Awan said, adding that both anterior and posterior segments of the eye were severely affected, making the case exceptionally challenging.
Doctors first carried out advanced retinal surgery to remove infected material from inside the eye and administered targeted antibiotics directly into the vitreous cavity, a technique considered essential in severe endophthalmitis cases where topical or systemic medicines alone are often insufficient.
Although the infection was eventually controlled, the patient subsequently developed retinal detachment, a serious complication in which the retina separates from the underlying tissue, threatening permanent loss of vision if not urgently repaired.
To manage the highly complex situation, surgeons adopted a specialised combined corneal and retinal surgical approach rarely performed locally. Initially, a temporary artificial cornea was used to gain clear visual access to the back of the eye, enabling surgeons to perform delicate retinal surgery and repair the detached retina.
Once the retinal procedure was completed and the retina stabilised, the team performed a corneal autograft by taking healthy corneal tissue from the patient’s other eye and transplanting it to restore corneal clarity and transparency.
Medical experts say this combined vitreoretinal and corneal reconstructive procedure requires an extraordinary level of surgical expertise, coordination and precision, and is usually reserved for the most severe and high risk eye conditions.
Following the surgery, the patient’s vision improved significantly, from only being able to perceive light to regaining the ability to see and count fingers, considered a meaningful functional recovery in such an advanced and complicated infection.
Ophthalmologists note that bleb related endophthalmitis remains a rare but devastating complication of glaucoma surgery and is frequently associated with delayed diagnosis or inadequate initial management. They stress the importance of early referral to specialised centres equipped with advanced ophthalmic surgical facilities.
“This case demonstrates that even in the most challenging situations, vision can still be salvaged with timely intervention, advanced technology and multidisciplinary expertise,” Prof. Dr. Amer Awan said.
Eye surgeons said the successful outcome marks a significant advancement in ophthalmic care in Pakistan and offers hope to patients suffering from complex eye infections and retinal complications that were previously considered almost impossible to treat locally.
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