‘I screamed with joy’ — ‘bionic eye’ surgery at Tygerberg Hospital gives the gift of sight

Jantjie Swarts, Dr Dony Mathew, an ophthalmologist and Ncane Badenhorst in Tyberberg Hospital where Swarts and Badenhorst each received an artificial cornea. Picture: Elsabé Brits

By Elsabé Brits

3 Feb 2025

After being blind for years, two patients recently each received an artificial cornea, and Tygerberg Hospital in the Western Cape hopes to continue providing this service to those who need it in future.

The keratoprosthesis (KPro) implantation looks a bit like a “bionic eye”. However, the fortunate patients who visited the Tygerberg Hospital Ophthalmology Clinic in Parow, Western Cape, for a checkup this week don’t mind this in the least.

Jantjie Swarts (56) from Malmesbury said he had an argument with his father and stepmother one day in 1993.

“They threw boiling water in my face. My eyes boiled that day.

“While in hospital, I prayed to God to give me a little bit of sight. He heard me, and I could see a bit with one eye.”

Dr Dony Mathew, an ophthalmologist who performed the surgery at Tygerberg Hospital, said Swarts could only see hand movements with one eye before the surgery.

At the end of 2024, Swarts received his “Black Friday Christmas box”.

“The day after the surgery, I woke up and walked towards the window. Could it be? I saw cars, everything.

“At first, I cried a little, and then I thanked God and the doctors. And my wife, Sara, who stood by me all these years. She could have left me,” he said.

Professor Derrick Smit from the Division of Ophthalmology at Stellenbosch University and Tygerberg Hospital, explained that the KPro is the last option when a patient cannot receive a “regular” donor cornea.

This is especially the case when there have been several transplant rejections before, and/or severe limbal stem cell deficiency.

The latter is when the system has been compromised and the body can’t regenerate healthy corneal tissue, making a traditional corneal transplant from a donor ineffective.

The KPro was conceptualised, designed and manufactured at the Massachusetts Eye and Ear hospital in Boston in the US, the only place in the world where it is produced.

Surgeons must submit their surgical CVs to prove they can perform these surgeries before registering as KPro surgeons. Mathew said it is a technically challenging procedure and each patient is different.

The price depends on the socioeconomic status of the country from which it is ordered. It can cost up to $5,000 in developed countries, but it costs about $2,000 per KPro in developing countries.

Smit, who also previously sought private funds to legally buy corneas from the US because of the extreme shortage of donors in South Africa, once again found a way.

The expenses were funded through a restaurant group with several restaurants at the V&A Waterfront, as well as a medical company specialising in providing machines and consumable items for cataract surgery.

eye surgery Jantjie Swarts, Dr Dony Mathew, an ophthalmologist, and Ncane Badenhorst in Tyberberg Hospital where Swarts and Badenhorst each received an artificial cornea. (Photo: Elsabé Brits)

“These were the first two [procedures] done in the public sector at Tygerberg Hospital. There are already some more patients who are likely to require the procedure in the future.

“Given the commitment from our private sponsors, we aim to continue providing this service to patients who may need it in future,” Smit said.

The Boston Type I Keratoprosthesis is the most commonly used KPro device at the moment. It consists of a clear plastic polymethyl methacrylate (PMMA) optic and back plate sandwiched around a corneal graft and secured with a titanium locking ring.

There is no human tissue involved and no chance of rejection. However, like any medical procedure, there is aftercare and healing involved.

Ncane Badenhorst (46) from Kraaifontein received her implant days before Swarts.

In 2010, she completely lost her sight in one eye when she was mugged in Durban. About five years ago, a virus (herpes zoster) infected the other eye, which still had sight.

“Why? If it had [only] gone for the eye that was already blind.”

Mathew explained that the infection was so bad that the eyelid was severely damaged and Badenhorst had to have plastic surgery to repair it.

Before the KPro implant, the doctors also had to restore the structural integrity of the eye. Badenhorst could only see light.

“As long as I could still see light, there was hope,” Badenhorst said. The morning after the implant, she could see.

“I screamed with joy! I can’t thank this place and the doctors enough.”

During their eye exams, Swarts said he was so thankful “that I would have crawled back here to say thank you”. Badenhorst teased him: “When you last saw your wife she was young, and when you saw her again, she was old. What did you do?”

Swarts responded: “It is not [about looks]. Love is blind.” DM

This story first appeared in our weekly Daily Maverick 168 newspaper, which is available countrywide for R35.

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