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| Taiwo Bilesanmi at a follow-up visit with Dr. Kahana. |
Oculoplastics service built on teamwork, tough cases
Taiwo Bilesanmi, now a teenager, lost his eye to cancer when he was just one year old and living in Nigeria. His family did not have access to a surgeon who could rebuild the child’s orbit, the bones and muscles that form the eye’s support. The proper supporting structure was essential if Taiwo were, one day, to have a new prosthetic eye created for him.
Reconstructive surgery can make a big difference in people’s lives, observes Kellogg oculoplastic surgeon Alon Kahana, M.D., Ph.D. At first, Taiwo was too young to care about the loss of his eye, according to his father. But as he grew older, he became sensitive to comments from his friends about his appearance. By the time Taiwo came to the Kellogg Eye Center for orbital reconstruction, the young boy was anxious, but ready for surgery that would allow him to have a new eye. Dr. Kahana was aware the surgery would not be simple. Taiwo, whose family now lives in Detroit, had gone for some 12 years without an eye or prosthesis, and as a result, the orbit had become malformed. Much of the supporting tissue was lost, and the bony structure had grown inward, displacing a silicone implant from an earlier surgery and making it impossible to fit a prosthetic eye.
There was one more obstacle, this one concerned with safety. Before Dr. Kahana would consider surgery, he insisted that Taiwo begin to wear polycarbonate glasses. Like his Kellogg colleagues, Dr. Kahana tells his patients they must protect their “good” eye with shatter-resistant lenses.
Dr. Kahana then presented his plan: replace the earlier implant with tissue from Taiwo’s thigh to create the supporting structure. There are several techniques a surgeon can use to reshape the orbit, and many nuances in performing the surgery, says Dr. Kahana. “The ultimate goal is to have good reconstruction that is long lasting and allows for a good prosthetic fit,” he says. “Orbital reconstruction can be easy to do but hard to do well.”
After surgery, Dr. Kahana was pleased at last to see a smile on his patient’s face. “I think he finally could see the light at the end of the tunnel,” says Dr. Kahana. Then Taiwo went on to see Gregory Dootz, Kellogg’s ocularist who has been creating and fitting prosthetic eyes for Kellogg patients for some 29 years.
One of three surgeons on Kellogg’s Eye Plastic, Orbital and Facial Cosmetic Surgery service, Dr. Kahana credits his colleagues with having built a strong practice that serves as a major referral center for difficult eye plastic surgery. Then too, there is the foresight of recently retired service chief, Bartley R. Frueh, M.D., who came to the Department to start the Eye Plastic Service nearly thirty years ago. One of his early decisions was to hire Gregory Dootz, says Dr. Kahana. “Dr. Frueh was an accomplished surgeon who knew that to do orbital reconstruction well it was essential to have an expert ocularist on staff and then work together as a team.”
Despite many doctor’s appointments and surgeries, Taiwo is very positive. His father offered strong encouragement, and Taiwo, now 15 years of age, says, “It was easy except for the surgery. It’s all OK now.”
For more information, see the Eye Plastic, Orbital and Facial Cosmetic Surgery service at the Kellogg Eye Center.
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