Surgery May Lead Boy Out Of Darkness

By TODD LESKANIC The Tampa Tribune

Published: Aug 11, 2007

Shortly after his birth, family members took pictures of Samuel Clanton as his mother held him in the neonatal intensive care unit of Lakeland Regional Medical Center.

Sam's parents, Jon and Yvonne Clanton, were elated. They had dealt with fertility issues for a year in trying to have a second child, so Sam's arrival on Feb. 11, 2004 - although eight weeks premature - was certainly a time for photographs.

As the family snapped away, Sam opened his eyes for the first time.

Yvonne Clanton felt her heart drop.

"Get a nurse," she said.

Sam's eyes were white with a bluish tint. Something was wrong.

The diagnosis was heartbreaking. Sam had Peter's Anomaly, a rare congenital disease marked by glaucoma and opaque corneas. The Clantons' baby boy was essentially blind, and the prognosis was bleak.

"It was devastating," Yvonne Clanton recalled. "With my age [she was 39], we were worried more about spina bifida and Down syndrome. We didn't even think about anything like this."

Sam's parents are dealing with other health challenges besides his eyes, including mental and physical developmental difficulties.

Clanton, who lives in Zephyrhills, spoke Thursday from the Ronald McDonald House near the University of Rochester Eye Institute. Her voice carried a ring of hope, the result of a groundbreaking surgery that Sam underwent Tuesday.

James Aquavella and a team of eight other physicians implanted an artificial cornea into Sam's left eye in a delicate four-hour operation that can only be performed by a handful of doctors in the world. Only about 60 children worldwide have received the plastic corneas, Aquavella said.

Sam is now one of them. He's already showing signs of being able to see out of his left eye, his mother said.

"In little ways, we already see him being able to see out of the eye," she said. "He's not going to have 20/20, and he'll probably have some problems, like astigmatism, later on. But the hope is he'll be able to read large print, and that's a long way from being blind."

Doctors are scheduled to operate on Sam's right eye Monday.

Envisioning Hope

Aquavella, a 30-year veteran of corneal surgery, began implanting the plastic corneas in infants in 2003 after a colleague redesigned an artificial implant discarded some 30 years ago as ineffective.

The new implants are particularly important for infants born with opaque corneas. Before the breakthrough, a baby's best hope was repeated cornea transplants.

Although the transplants can be effective for adults, they almost always fail in children because of their active immune systems.

Aquavella said many surgeons have stopped doing cornea transplants on infants.

"In adults, you have an 85 [percent] or 90 percent chance of having a successful operation," he said. "In infants, you have less than 10 percent. They reject these things, bang, bang, bang."

Yvonne and Jon Clanton were lost following Sam's birth. They didn't know what to do, nor were they receiving much advice from the local physicians, who knew little about Peter's Anomaly. The Clantons began investigating; corneal transplants seemed to be their only option.

"I mean in the very beginning, the doctors in Lakeland didn't know enough to tell us there might be an option of that," Yvonne Clanton said. "We didn't think there was anything that could be done. We just thought we had a son that would be blind."

Sam had a donor cornea transplanted into his right eye at 6 weeks old. Three months later, he received one in his left eye. The transplants gave him some vision, enough for him to put his right eye on the television screen to watch "Sesame Street."

He would hold his toy trucks up to his eyes so he could see them.

Both transplanted corneas didn't take long to begin clouding, however. That's when a doctor mentioned the Rochester Eye Institute and Aquavella's work.

'Wonderful Little Guy'

Yvonne didn't believe it, at first.

"I felt like he was telling us that to give us something so that I wouldn't cry," she said.

Further research proved the news to be true. On July 30, the Clantons packed Sam, their 11-year-old son, Stephen, and their adopted son, Shadrach, into the family car for the 30-hour drive to Rochester.

They've been there ever since.

If Monday's surgery goes well, the family plans to start for home Thursday. Aquavella said it will take four to five years to determine how well Sam will see with his new corneas.

For Yvonne and Jon Clanton, every extra mile has been worth it.

"Sam has taught us a lot," Yvonne said. "He's the most wonderful little guy. Of course, I would have preferred everything be normal, but I wouldn't trade him for the world. It was such an effort to get him and we're so glad we have him."

Reporter Todd Leskanic can be reached at (352) 521-3156 or tleskanic@tampatrib.com.