Great Ormond Street Hospital uses pioneering surgical technique to save baby Hadi’s sight
Born too soon
For Hadi Mansoor, life began a little too early. “I was six months pregnant and I felt a pressure in my stomach,” explains Hadi’s mother, Marwa Ebrahim. “Hadi was my first child, and I didn’t realise there was anything wrong. I went to the clinic and by the time I made it to the hospital by ambulance I gave birth.” Hadi was born premature and had to spend the next three months in neonatal intensive care in Bahrain. “Hadi had to be given oxygen – he was born blue, with jaundice and a hole in his heart. When he was born he was only kilo.” Hadi’s father adds.
Thankfully, Hadi recovered under the expert care of the doctors in Bahrain, but just before the family were discharged, they discovered that Hadi had Retinopathy of Prematurity (ROP). ROP is a potentially blinding condition that occurs in premature babies when the blood vessels have not had the chance to develop fully in the womb. It is one of the most common causes for vision loss in childhood, and can lead to lifelong vision impairment and blindness. Hadi received laser treatment in Bahrain, but unfortunately the disease progressed despite the treatment, with retinal detachment in both eyes which would have led to blindness without expert treatment. “Our doctor suggested we go abroad for the specialist treatment needed to save his sight.” Marwa states.
Coming to GOSH
Hadi and his family were sent to Great Ormond Street Hospital for Children (GOSH) in London for treatment. “Hadi came to the hospital when he was only a few months old and presented with advanced retinal detachment in both eyes. I believe that without treatment Hadi would have almost certainly lost sight in both eyes.” Mr. Chien Wong, Hadi’s consultant at GOSH, explains. “You only have a very narrow window of opportunity in a premature baby’s first few months of life to perform treatment to preserve enough sight in the eye to allow the child to grow up and potentially lead an independent or even normal life. Fortunately, I was able to see Hadi within that timeframe and save his sight.”
Mr. Wong is an expert in vitreoretinal surgery and a new pioneering surgical
technique, called endoscopic vitrectomy, which he used in Hadi’s operation to preserve Hadi’s sight. “GOSH is one of only two centres in the world that can do this new innovative technique,” Mr Wong explains. “This technique is unique because it allows us to preserve the native lens of a baby while at the same time optimising the chance of fixing the retina, which is very important to give the child the best possible long term vision. Retinal detachment operations are very complex and any mistake can lead to irreversible blindness; traditionally to reduce the risk of retinal complications in surgery you would have to sacrifice the natural lens, so even if the operation is successful, the potential for doing well visually in the future would be impacted. However, with this new technique we are able to preserve the native lens, which gives the child the best single opportunity to optimise their visual potential for the rest of the child’s life, and many of the children of this generation could be living to a hundred years old!”
Vision for life
Hadi, now 14-months old, returns regularly to GOSH for check-ups, and Mr Wong remains happy about his prospects. “Having seen Hadi eight months after the operation I am delighted to say he is doing very well.” Mr Wong says, “Marwa has told me how he can pick up small objects and that he has good visual behaviour at home. Overall I was able to do a very complex surgery and still preserve the native lenses in both eyes. He has gone from little to no sight in both eyes to now likely being able to live a full, independent life.” Hadi is a cheerful, active toddler and wears his special blue glasses happily. “Hadi loves to try and walk and be active,” Hadi’s father smiles, “Mr Wong is an excellent doctor and very good with children.”
“We would like to thank the Bahrain government for sending us to GOSH,” Marwa says emotionally. The Bahrain embassy funded the family to come to the UK for the sight-saving surgery. “We would also like to thank the doctors at GOSH for saving Hadi’s sight.” The family plan to return again in six months for their next check-up and remain hopeful about Hadi’s future.
Mr. Wong is a consultant at Great Ormond Street Hospital, Moorfields Eye Hospital and the Royal Free Hospital in London and is a world expert in paediatric vitreoretinal surgery, endoscopic vitrectomy in babies and young children, and paediatric retinovascular diseases. He also manages adults with vitreoretinal diseases. He is one of only a handful of surgeons in the world with significant expertise in a new surgical technique for the treatment of ROP and introduced the technique to GOSH in 2014, making GOSH one of only two hospitals in the world that can perform this sight-saving technique. GOSH was the first hospital in the UK to establish paediatric ophthalmology as a subspecialty, recognising that disorders affecting children’s eyes are frequently very different to those affecting adults. Recently Mr Wong was placed at number 13 in The Ophthalmologist's Power List of 2017.
All about GOSH
Great Ormond Street Hospital in London is recognised as one of the few truly world-class hospitals for children. As a global leader, GOSH has top clinical and research experts working every day to find new and better ways to treat children. While breakthroughs and medical expertise are essential to the treatment of patients, GOSH also places great emphasis on the support and care provided for children by nurturing an open and supportive atmosphere, ensuring that parents and patients are well informed and closely involved in the treatment process. Children receive the highest standards of care and attention from the expert team of medical and support staff during their stay at GOSH, and are always treated with respect, trust, concern and openness.