Eyes Without a Face:
Stem Cell Research and Corneal Implants

Part II—"New Hope"

by
Kari Mergenhagen, University at Buffalo, State University of New York

The next few years of my life were difficult, but I was determined to do more than just survive.  I wanted to be independent, so I began the arduous process of learning how to function in an entirely new life.  I had to learn how to dress, eat, play, and navigate the house.  After several years I became proficient in reading and typing Braille.  I acquired a Seeing Eye dog and a special "blind" cane, both of which acted as surrogate eyes.  I developed a reliance on my other senses and once again started flourishing socially and in school. 

Outwardly I was adjusting well, but inside I felt as though I were enveloped in a shroud of darkness.  I intently focused on my other senses.  These compensated to some extent.  But I refused to admit I would never really see again.  I enthusiastically pursued cornea transplants.  When my third transplant failed, I realized it was time to move on.

After college, I married John, a kind, sensitive, and patient man.  His only fault was a tendency to be overprotective.  A daughter, Rose, blessed our lives several years later and with a little help I was able to gain the confidence needed to manage the job of motherhood. 

When I caressed Rose's soft, pudgy cheeks, ran my fingers through her fine, silky hair, or heard her baby gibberish I would try to imagine her features in my mind.  This surrogate image was something my other senses couldn't compensate for and I began to feel a huge void.

I longed for a true picture.  I wanted to see her face when she pouted, giggled, when she was surprised.  Conjectures of the mind were no longer acceptable to me, so I sought advice from Dr. Cooper, a friend and my ophthalmologist for the past 10 years.  Incredibly, he informed me about a study being conducted at the University Medical Center that might help me to regain some sight.

"Lucy, this is a clinical study that is accepting patients in which conventional corneal transplants aren't effective.  It involves the use of corneal stem cell implants.  I believe you should look into it.  You seem to fit all the criteria."

"I've had several unsuccessful transplants.  What makes you think that this would be any different?" I was cautiously enthused, but didn't want to pursue a pipedream.

"Basically, the injury to your cornea was so severe that your stem cells were damaged.  The stem cells are important because they provide a sort of clear surface over the cornea.  In the normal eye the cells on this surface are constantly being knocked off by blinking or rubbing your eye and then they are replaced.  In eyes in which the cornea has been severely impaired, like yours, the ability to do this is missing," Dr. Cooper explained.  "I really think you should look into this.  If you are interested, call this number and ask for Dr. Star.  Tell him to contact me for your records."

I had a feeling of euphoria as Dr. Cooper placed the slip of paper in my hand.  Soon I might actually be able to see my daughter.  I couldn't wait to discuss the prospects with John.  Unfortunately, John lacked my enthusiasm.

"Honey, I love you just the way you are.  I want to do what's best for you, but you know how I feel about using stem cells." John tried to reason with me.  "There has to be different way.  I could never approve of killing a fetus to make our lives better.  I would feel as though I was destroying a child, like Rose.  I don't think we should support any research with stem cells."

"John, don't assume this procedure is like that." I could feel my voice rising as I tried to make my point.  "I just want to look into the process.  I promise if it seems unethical, I won't do it, but to have my sight... to see Rose's expressions... to watch her grow up....  It would be incredible.  Please explore this with me," I begged.

"I just don't know ...." John shook his head.  "Look at the disappointments you've endured in the past.  I don't want to see you go through that again, and I can't stand for you to be used as a guinea pig," He could see how upset I was with his response.  He put his arm around me.  "Lucy, I'll look into it with you, but no promises."

Questions:

  1. Why do some cornea transplants fail?
  2. What is a stem cell?
    1. What is the difference between a totipotent, pluripotent, multipotent and unipotent stem cell?
  3. How do adult and embryonic stem cells differ?
  4. What type of stem cell is used to reconstruct the cornea in this procedure, why are they important, and what problems have been encountered in using this type of stem cell?
  5. How do stem cells normally function in the cornea?
  6. What are some major concerns with adult stem cell use?

Go to Part III—"A Stem Cell Solution?"

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