By Chris Mayhew
The Cincinnati Enquirer

Dr. Edward J. Holland helped restore eyesight in one of Peggy Power's eyes. (Patrick Reddy photos) | ZOOM |

EDGEWOOD - Minneapolis resident Peggy Power went blind in 1999 after suffering a rare allergic reaction to a medication.

But now, the 46-year-old mother of five can see again from one of her eyes after receiving an unusual, high-tech treatment from Tristate eye surgeon Dr. Edward J.Holland.

The treatment involved a combination of a stem-cell transplant and a cornea transplant, conducted over several months. Dr. Holland, who co-invented the procedure in the early 1990s with a team of doctors at the University of Minnesota, says more people are benefiting from it as the technique is used for a growing range of eye-damaging conditions.

"In 1995 we were doing 15 cases, and this year have done close to 55 cases, and next year it will be more," Dr. Holland said.

Mrs. Power suffers from a rare condition called Stephens-Johnson Syndrome.

The condition, which can be triggered by reactions to any of several medications, resulted in Mrs. Power losing 93 percent of her skin, including so much damage to tissue around her eyes that her eyelids fused shut.Stevens-Johnson Syndrome is "random and rare," said Dr. Holland.

Dr. Holland examines Mrs. Power in his Edgewood office. | ZOOM |

The syndrome can be triggered by almost any kind of over-the-counter drug, but most often anti-convulsants, antibiotics (such as sulfa, penicillin and cephalosporin) and anti-inflammatory medications are implicated, according to the Stevens-Johnson Syndrome Foundation.

Doctors believe an over-the-counter pain reliever to treat arthritis triggered Mrs. Power's illness. As a result, Mrs. Power's own immune system started attacking her skin, Dr. Holland said.

Mrs. Power spent nine weeks in a burn unit at Regents Hospital in St. Paul, Minn., to treat the loss of skin on the rest of her body.

Restoring sight to her left eye has involved three surgeries.

The first, in September 2001, used stem cells from her sister to free her eyelids. Mrs. Power's nasal tissue was used to reline her eyelids.

Then, in January 2002, Dr. Holland performed a stem-cell transplant using tissue from her son and from a cadaver to replace a damaged ring of tissue at the base of the cornea, the clear dome that covers the iris. That ring contains stem cells that produce a clear type of skin that covers and protects the cornea.

In November 2002, Mrs. Power received a cornea transplant; hers had been damaged by the original allergic reaction.

Within a day of the final treatment, Mrs. Power could see again. Her vision will continue to improve slightly as stitches are removed over the next several months.

"She's still in a healing phase," Dr. Holland said. "Now, she sees 20/50 to 20/60 and can read large print."

STEVENS-JOHNSON SYNDROME

Discovered: 1922, by pediatricians A.M. Stevens and S.C. Johnson. Symptoms: Rash, blisters or red skin splotches; persistent fever; blisters in the mouth, eyes, ears, nose or genital area; swelling of eyelids and red eyes; conjunctivitis; and flu-like symptoms. Number of cases: It's a rare disease, but there is no accurate count of cases. Patient profile: Affects people of all ages, but majority are children. More female cases than male have been reported. Triggers: Almost any medication, including over-the-counter drugs, can cause or trigger it. Commonly implicated: anti-convulsants, antibiotics (such as sulfa, penicillin and cephalosporin) and anti-inflammatory medications.

Dr. Holland said doctors even hope Mrs. Power will be able to get her driver's license back in the next year or two.

Mrs. Power, whose children range in age from 14 to 23, said it has been hard to adjust to life without her vision. It was especially hard to miss seeing events like proms and basketball games, said the stay-at-home mom.

"I can see my kids now, I couldn't see the changes they were going through," she said.

"It truly is a miracle what they have done. I consider myself very lucky, and I feel I've gotten closer to God."

Mrs. Power said she is still considering whether to have the same procedure performed on her right eye, but has not decided.

"I want to maintain this eye," she said. "It's not like it's fine."

Mrs. Power takes pills and special eye drops several times a day to treat her eye and prevent tissue rejection.

Dr. Holland is director of cornea services for the Cincinnati Eye Institute. Since moving to Greater Cincinnati in March 2000, Dr. Holland has seen patients at offices in Edgewood and Cincinnati.

Breakthroughs in medicines

Dr. Holland said improved anti-rejection medications have helped make stem-cell transplants more successful

In the early 1990s, only patients with minor chemical burns or hereditary cornea problems from the lack of stem cells, and otherwise healthy eyes were considered for transplants.

After the anti-rejection program was introduced in the mid-1990s, patients who had major inflammatory damage to their eyes and the surrounding membrane could also be included in the surgery.

The medication program, similar to treatment for kidney transplants, starts at a higher dose, then is gradually tapered to lower doses. Many patients can never fully quit taking anti-rejection medications, he said.

"Two years is the critical process where you stop worrying most of the time," Dr. Holland said. "She's out of the danger zone a bit, but the eye is never normal. ... She will always need to see an eye care specialist."

E-mail cmayhew@enquirer.com