When you are one of the first non-Libyans to do both in the Tripoli Eye Hospital, “that’s pretty exciting,” notes Kevin Lavery, M.D., a cornea surgeon in Jackson, Michigan, and clinical professor of Ophthalmology at the Wayne State University School of Medicine.

Dr. Lavery was one member of an international team of ophthalmologists that conducted an eight day mission in Libya through ORBIS, a humanitarian organization whose mission is to preserve and restore eyesight by strengthening local resources in developing areas. Ophthalmologists volunteer to travel to developing countries through the world, performing procedures together with surgeons from the host countries, teaching them current techniques and offering standards of practice for ancillary staff.

This was the eighth mission for Dr. Lavery, who has been to Cuba, India, Bangladesh, Kurdistan, Peru, China, and Ethiopia. In Ethiopia, he helped establish the first eye bank in Africa.

Midwest Eye-Banks collaborates regularly with its affiliated cornea surgeons who participate in ORBIS missions. In this case, the Michigan Eye-Bank provided three corneas for use in Libya. There are more than 1,000 people on the waiting list for a corneal transplant in Lybia, and no corneal surgeons are available to serve the six million people in that country.

“I enjoy teaching,” says Dr. Lavery. Although ORBIS has fully equipped operating rooms suites on its transport plane, its philosophy is to “go into their hospitals with their equipment and show them what’s possible,” he adds. “You need to show them a cogent argument of where they are, where the rest of the worlds is and where they should be” in terms of corneal transplant surgery.

The ORBIS team includes biomedical technicians who repair malfunctioning equipment. More than 60 percent of the medical equipment in countries visited by ORBIS does not work, Dr. Lavery says.

Being an American in a North African Arab nation like Libya may seem intimidating. However, Dr. Lavery found it rewarding in its truest humanitarian sense. “Libyans were very supportive of Americans,” he says. Wherever he went he was told, “We love America.”

Despite the years of animosity between the governments of Lybia and the United States, he says at the “people level” the United States is revered as “the land of opportunity, freedom, and economic prosperity.”

Quality of life is as important as the length of life, whether you’re an infant or 99 years old. The ability to see is critical to personal freedom and a satisfying life, according to David Verdier, M.D., a corneal surgeon in Grand Rapids, Michigan

Dr. Verdier is one of the more active corneal surgeons in Michigan, performing about 100 cornea transplants procedures annually. Bit it’s not the volume of procedures or even the procedure itself that interests him as much as his ability to relate to patients on a long-term basis.

Prior to selecting ophthalmology as his specialty, Dr. Verdier began a family medicine residency at the University of Michigan Medical Center. That, by nature, offers a physician the chance to establish a long-term bond with the patient. “That really attracts me,” he says.

When he focused his practice on ophthalmology and corneal surgery at the University of Iowa, Dr. Verdier discovered that he could have similar experience with his patients. Corneal surgery requires about a year and a half to follow-up.

“I was attracted to transplants from the day I started my ophthalmology residency…I like the procedure, I like the challenges, I like the long term commitment and I love the results.”

Dr. Verdier returned to the Grand rapids area- his hometown- in 1984 to become the first corneal surgeon in west Michigan. He has had many memorable cases. However, three come to mind immediately when considering the value of cornea surgery.

His ultimate clinical challenge was to transplant a cornea in an infant- the youngest cornea recipient on record. At three months, the infant weighed less than a pound. A nurse noticed what appeared to be a tear on his cheek. It was his cornea.

“He’d had a silent cornea melt- a ruptured eye and melted cornea,” Dr. Verdier explains. He needed a cornea or he would lose his eye.

At the time, there were no instruments to cut the cornea to fir the infant’s eye, so Dr. Verdier has to improvise. “It was a challenge, yet it actually worked quite well,” he says.

Now 10 years old, the boy is well. He has some sight in his eye, but most importantly, the eye was saved. “By restoring the integrity of his eye with the new cornea [as an infant], he was still at an age where his skill was growing. Had we done an enucleation [removal of the eye], he would have ended up with a misshapen eye socket. Now he has little visit and a normal appearance.”

Few People, other than astronomers, appreciate the stars as much as one of Dr. Verdier’s patients. A man in his 60s has experienced poor vision thoughtout his life because of childhood eye infections. “He got by,” says Dr. Verdier. “He wasn’t totally disabled, but he was never able to do what sighted people could do. He never drove. Interestingly enough, he could read, but it was difficult.”

The man was a candidate for corneal transplants in both eyes. During a follow-up clinic visit with the patient after his surgery, Dr. Verdier noticed that the man was crying.

“He was a big, strong guy. I’ve never seen him down about anything, he recalls. “I asked him, ‘Is there anything troubling you?’ He said, “No, these are tears of joy. I saw stars for the first time last night since I was six years old.’ You can’t make that up in movie scripts. It was probably one of the happiest moments I’ve had with a patient- to have him share that with me. Sometimes, we don’t realize how important vision is…what a wonderful operation this is.”

Dr. Verdier would also learn that the man undertook “a whirlwind of activity around the house…making up for the 50 years of lost vision.”

The value of vision has no age barrier, as Dr. Verdier learned with a 99-year-old man. At such an advance age, a physician must weight the benefit of the procedure against its cost and relative value. The usual screen- ‘Is the quality of vision preventing a patient from doing the things they life to do or need to do?’- doesn’t apply when the patient is approaching his centennial birthday. However, this patient was different.

“You’re 99. Is it worth it?” he asked his patient. “I don’t know how long you or I will live, but you will have a year of follow-up.”

He had one good eye and one bad. In most lives, one eye is enough to read, move about and generally visualize life satisfactorily. However, for this man- vision in his bad eye was progressively compromised by painful complications from a cataract surgery- two eyes were definitely better than one.

He was a hunter who brought home a deer every year since 1926.

“It’s my shootin’ eye,” he told Dr. Verdier.

“that didn’t even register to me,” the surgeon recalls. “Your shooting eye?!” The man’s daughter told Dr. Verdier that he has shot a deer every year since 1926. That was one of his passions in life. He was bound and determined to go out the next year and shoot another deer.”

The procedure was successful and the patient shot a deer the following hunting season. In fact, he experienced three more hunting seasons before his passing at age 104.

This is what Dr. Verdier values in corneal surgery- not just the challenge of the procedure, but the opportunity of knowing people whose lives are enhanced because of the procedure.

Dr. Verdier is sensitive to the importance of the donor family’s gift of corneas, as well as the importance of cornea recovery, evaluation and distribution by eye banks. As a member of the Medical Advisory Board of the Eye-Bank Association of America, he reviews eye banking procedures regularly.

“I have come to appreciate what a challenge it is, and how complicated it is to make this all happen.  ...We [in Michigan] have an as good an eye bank as I know of.

“I’ve done over 1,000 corneal transplants in Michigan,” with most of the corneal tissue coming from the Michigan Eye-Bank. “There is nothing that beats experience in knowing what to expect. I’ve been impressed with the service and the quality of the [Michigan] Eye-Bank. We’re very lucky.”

The Michigan Eye-Bank also provided eye tissue for Dr. Verdier’s humanitarian mission to China last year. He was a member of a delegation of surgeons who trained Chinese eye surgeons in corneal transplantation techniques. He’s planning an upcoming mission to India.

Whether teaching a corneal surgeon, performing transplant procedures or examining a patient whose life is changed by restored sight, Dr. Verdier’s own life is enriched.

“I think that quality of life is just as important as length of life,” he says. “When you talk about other transplant procedures (and their ability to extend life), a corneal transplant doesn’t extend life, bit in a lot of ways improves the quality of life more than anything you could do for these patients.

“Patients are often afraid of any eye surgery- cataract surgery or corneal surgery- because they recognize that their vision is their independence to a large extent.

“In terms of quality of life and maintaining someone’s independence, the ability to see or regain sight is near the top of the list. It is very fulfilling.”