20/20 at 20
Aug 28, 2018 06:00AM
By MED Magazine
By Alex Strauss
Mike Neiman figures he was just 14 or 15 years old when he first began to notice that his eyesight was not what it should be.
“My vision would become cloudy, like a windshield covered with snow and ice,” recalls the Huron native who now lives in Renner. “It was always worse in the morning, but it seemed to get better throughout the day. Then when I went to sleep, it would start all over again.”
His optometrist prescribed glasses and eye drops, neither of which helped. Meanwhile, Mike got “tried to make it work.” He got through school by sitting in the front row and struggled to play high school sports. Things worsened throughout college. By the time he was 29, even doing work at the computer was proving very difficult.
Things came to a head at a golf tournament in Mitchell in 1998.
“It was early in the morning and my vision was very cloudy,” he says. “At one point early in the day, I almost stepped on my ball right at my feet. I picked it up and said ‘I can’t play today.’ I hadn’t told anyone what was going on.”
Fortunately, the course’s golf pro recognized a serious vision problem and suggested that Mike see an ophthalmologist in Sioux Falls. It took just minutes to learn that he had a serious case of Fuch’s dystrophy, a hereditary condition that causes the cornea to become waterlogged.
Within days, Mike underwent penetrating keratoplasty (PK) on the first eye, a full-thickness corneal transplant procedure that was the gold standard for the treatment of corneal diseases at the time.
“I could tell right away that my vision was brighter and clearer, even though it was still blurry,” he says. Fourteen month later, in 1999, Mike had PK on his second eye and was able to see the freckles on his young son’s nose for the first time. In 2005, he underwent laser surgery on his transplanted tissue which gave him 20/20 vision without glasses or contacts.
“Nieman’s transplant is special because he is among the 71 percent of PK transplants with 20/20 vision after 15 years,” says Marcy Dimond, CEO of Dakota Lions Sight and Health, which procures and prepares tissue for transplants like Mike’s “Beyond the 15-year data point, the graft failure rate is undocumented.”
Today, 95 percent of cornea transplants taking place in Minnesota and the Dakotas are endothelial keratoplasty (EK), where only a layer of endothelial cells are transplanted. For these transplants, DLSH staff now perform advanced processing of the corneal tissue, saving the surgeon time and eliminating the risk of tissue damage from additional manipulation.
DLSH is one of just a small handful of eye banks around the country now offering these DMEK pre-loads, which are the new gold standard for treating Fuch’s dystrophy.
“The future is bright for Nieman,” says Dimond. “Even if his grafts begin to fail, he would not require a full thickness transplant. Today’s technologies would allow for a ‘tune-up’, of sorts. The affected endothelial cells could be removed and a new set of donor endothelial cells could be transplanted through a 2 mm incision.”
“I did not fully appreciate at the time what it really meant to receive donor tissue,” admits Nieman, who now serve on the DLSH board of directors. “It is truly a miracle that this procedure was available, that there are people here capable doing it, and that there are families with the generosity and foresight to be organ and tissue donors.”
“Without that, I would have had a very limited life. Now, I can do all the things that everyone takes for granted - watch my daughters dance, work on the computer, read, attend kids events and all of that. I respect and honor my eyes because they are literally a gift.”
Learn more about DMEK preloads
Find out how to request tissue from DLSH