Though she might not fully grasp the specifics, 6-year-old Mia Johnson understands that something momentous is about to happen to her.
Mia is legally blind in her right eye because of scarring on her cornea (the surface of the eye) and is preparing to undergo a rare juvenile corneal transplant in Las Vegas later this month.
It’s rare because it will be only the second operation of its type performed in Las Vegas in the last five years. It’s also rare because it will be a second chance for Mia — who had a corneal transplant at UCLA Medical Center in 2006 that wasn’t successful.
Despite her trials, Mia is energetic, vivacious and she demonstrates a sobering grip on what is ahead of her, even if she doesn’t quite understand it all.
Before an interview can begin, Mia insists that she be allowed to ask questions first. Her first: “This might sound weird or funky, but where is my eye going to come from? A dead body, or what?”
Her surgeon, Dr. Jack Abrams, fields this one.
“It comes from a kind person who decided that when they pass, they want to help other people,” he explains.
Mia twirls a curly lock of hair in her finger while she considers the answer, then nods.
Within moments of seeing her tear through Abrams’ office, it becomes obvious that Mia hasn’t allowed her visual impairment to slow her down. She tells all about her first grade teacher at Glen Taylor Elementary School in Henderson, she proudly recites the high points of the book she just learned to read, and she’s wearing a cast right now -– the result of a fall on the monkey bars.
“She’s very energetic; she’s very lively, very sociable,” Abrams said of Mia. “If I could do anything to help her get through school, see better and have a better quality of life, then that’s the goal.”
Abrams has been treating Mia since her mother brought her to him in January with a dangerous infection in the eye that had received the corneal transplant. In his examination and treatment, Abrams realized that the transplant had failed, and unless another one could be done within the next year, Mia would likely lose vision in the eye forever.
After UCLA declined to operate a second time, Abrams, who operates the Abrams Eye Institute, began preparations to do the surgery himself –- a lengthy process of getting insurance companies to sign off on the surgery, finding an adequately equipped surgery center in Las Vegas, and making sure Mia is healthy enough for a second attempt.
The surgery is a complicated one, even by medical standards. Abrams will have to perform the entire procedure under a microscope, using a circular saw to cut away Mia’s cornea, then stitching the new one in place with 16 sutures that are just 1/3 the thickness of a human hair.
Abrams said he has done hundreds of corneal transplants on adults, but only about a dozen on children. They are a rare procedure on children because children are less likely to be healthy enough to undergo the procedure, and the success rate hovers around 50 percent for children, while reaching 90 percent for adults, Abrams said.
During their frequent visits, Mia has bonded with Abrams and her staff. On one occasion not too long ago, she found Abrams’ card in her mom’s wallet and called the number to confirm her next appointment.
Though Abrams was not in the office at the time, Mia spent a few minutes chatting on the phone with his assistants before her mother realized what she had done.
Abrams said Mia has as good a chance as any child of having a successful surgery –- she is in great overall health and her eye, apart from the scarred cornea, is in great health as well.
Mia knows enough about the surgery to be nervous, but she also knows enough to have hope.
“I’m sad and scared,” she said. “(But) I’m happy to have a new eye so that I can see out of it.”