Transforming Transplant

By Jane Lerner

December 28, 2003

None of the presents that he got for Christmas came close to the gift that Juan Llanos received last month.

The 16-year-old Haverstraw boy underwent a cornea transplant to replace part of his diseased eye.

Overnight, the darkness that had limited his world for more than a year gave way to light.

"As soon as they took the bandages off, I knew it worked," Llanos recalled of that November day. "I could see the doctor's face. I could see my brother. I could see again."

Llanos' world went dark a little more than a year before when, over the course of just a couple of days, he developed an unusual condition called keratoconus.

The progressive eye disease causes the cornea -- the outer covering of the eye -- to form into a bulging, cone shape.

"It's like waking up one morning and you have a small pea stuck to the center of your eye," said Dr. Gerald Zaidman, the ophthalmologist at Westchester Medial Center in Valhalla who treated Juan.

The disease itself isn't that rare -- about 100,000 people develop it every year. It usually causes vision loss over many years.

But the suddenness with which it robbed the teenager of his sight was nearly unheard of, Zaidman said.

And then, just days after Llanos lost vision in one eye, the same thing happened in the other, leaving him blind.

There are only a handful of cases recorded in medical history of the disease occurring in both eyes so quickly and resulting in blindness, Zaidman said.

"It's like winning two lotteries simultaneously," Zaidman said.

Llanos recalls feeling anything but lucky.

The youngster was living with his parents in the Dominican Republic. But they decided to send him to New York to be with his 14 brothers and sisters, almost all of whom live in the Haverstraw area.

He started attending Haverstraw Middle School in September 2002. It was just two months later that he woke up one morning unable to see.

"It looked like he had a marble sticking out of his eye," recalled his brother Domingo Llanos.

His family took him to an eye doctor, who prescribed some eye drops and told him to come back in several weeks.

But then the same thing happened just days later in the other eye, blinding him.

"If you put your face right next to his face, he couldn't see you," Domingo Llanos said.

Juan Llanos had to stop going to school last year and was taught at home by a tutor provided by the school district.

The worst part was the boredom, he said.

"I couldn't go anywhere," he said. "Someone had to lead me everywhere I went."

His brothers took him to see Zaidman at Westchester Medical Center.

"It was a very unusual case," Zaidman said.

It was clear that Llanos was going to need a cornea transplant to restore his vision, Zaidman said.

Corneas were the first part of the body successfully transplanted, according to Lucia Orduz, public education coordinator for the Eye-Bank for Sight Restoration, which collects, processes and distributes eye tissue for people in the New York metropolitan area, including Rockland and Westchester.

Cornea transplants aren't the answer for all eye diseases, she said.

But for eye disorders like the one Llanos had, a cornea transplant has dramatic results.

There is a high success rate for the operation, according to Orduz. That's because there are no blood vessels in the cornea, eliminating the chance that the recipients will reject the new organ.

Donors and recipients are matched mainly on the basis of age.

All Llanos knows about the person who donated a cornea to him is that it was a 30-year-old man.

He's grateful for the donor's contribution.

"But I feel sad that someone had to die so I could see again," he said.

Even though Zaidman told him soon after he lost his vision in the fall of 2002 that he would need a cornea transplant, Llanos had to wait until November for his first operation.

That's because the surgery can't be performed until all the swelling in the eye subsides.

He had the outpatient surgery Nov. 13 and went back to his doctor's office the next day.

Llanos was frightened as Zaidman removed the bandages.

"He didn't even have to say anything," his brother Domingo recalled. "All he did was smile."

The teenager has resumed a normal life since the operation and is now a freshman at North Rockland High School.

With the success of Llanos' transplant, Zaidman said the teen would be able to drive.

Llanos will have a second cornea transplant in the next several months.

His only regret is that his mother, Ligia Polanco, was not there to witness his joy when his sight returned.

She lives in the Dominican Republic and is unable to get travel papers to visit him.

"I miss her a lot," Llanos said. "I can't wait to see her."

Send e-mail to Jane Lerner .

Copyright © 2003 The Journal News.

This article posted January 17, 2004.