A young student who had to drop out of university when his vision was severely affected by keratoconus has regained his sight, thanks to a successful corneal transplant at the Universitas Annex Hospital, led by Professor Wayne Marais, head of the Department of Ophthalmology from the University of the Free State (UFS).
The life-changing procedure was made possible by donor tissue from a young organ donor from Bloemfontein. The donor tissue was retrieved by the team from the Bay Tissue Institute under the guidance of Dr Theunis Botha, with the assistance of Ryan Scheepers, Dr Joshua Cummings from the Universitas Hospital, and the team at the Bloemfontein Eye and Laser Clinic.
The operation took place on 26 May.
Marais described keratoconus as a progressive condition in which the cornea becomes thin and irregular, leading to distortion, scarring and significant visual loss.
The condition of the 21-year-old student had progressed to the point where he had to pause his studies at the University of Pretoria.
“For a young person, this is more than a medical setback – it is the interruption of education, independence, and future direction,” said Marais. “This surgery represents the restoration of possibility.”
With a corneal transplant, the damaged or diseased cornea, the clear dome-shaped tissue at the front of the eye, is replaced with healthy donor tissue.
“The cornea is arguably the most vital refractive part of the eye that focuses light to produce clear vision,” added Marais.
During the transplant, a surgeon will carefully remove the damaged cornea and sutures the healthy donor tissue into place with sutures finer than a human hair.
Professor Vasu Reddy, Deputy Vice-Chancellor: Research, Innovation and Postgraduate Studies, said the milestone demonstrates how health innovation, research, and clinical excellence can create meaningful societal impact.
“Innovation at the UFS … is restoring sight, rebuilding futures, and advancing human possibility.”
Not difficult but rare
Within the department, and under the leadership of Marais, corneal transplantation has become part of a broader commitment to restoring vision, expanding access to subspecialist care, and developing the next generation of ophthalmologists.
According to Cummings, the actual surgery is not difficult, but it has become very rare – especially in the public sector – due to a lack of corneal tissue, as no one is donating corneas. In fact, the decline in numbers of donors is alarming.
“About 20 years ago, there were many more corneal transplants than there are today, as there was more tissue available, due to various factors. I recently read an article stating that the number of transplants has dropped by almost 80% since then.
“Technically, the procedure is straightforward: we use special trephines to cut out the donor tissue and the damaged cornea to specific measurements. Often, the damaged cornea needs to be cut with specific left- and right-handed corneal scissors. The donor tissue is then placed on the recipient and sutured into place with about 16 sutures around the edge of the graft, so in the end it almost looks like a clock.”
The difficulty, Cummings adds, lies in the suturing and the tension on the sutures, as well as the accuracy in the placement of the sutures to try to reduce the amount of astigmatism caused by the warping of the tissue from the sutures.
Marais said this moment also serves as a reminder of the profound impact of organ and tissue donation. A single donor can save up to seven lives through organ donation and restore or transform the lives of many more through tissue donation, including restoring sight through corneal grafting.
Anyone wishing to become a donor can register through the Organ Donor Foundation of South Africa, either online or by obtaining a donor card.
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