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Roswell surgeon’s miracle of sight

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Cataract patient Robuti. (Submitted Photo)

Dr. Sally Mellgren, of Roswell, has done thousands of eye surgeries in her career as an ophthalmologist — not only in this country but as a longtime volunteer with Canvasback Missions, “bringing God’s love through healing hands” to the islands of Micronesia.

With more than half a dozen arduous mission trips under her belt, Dr. Mellgren decided she was not going on a mission trip this year. But she had second thoughts. “I felt impressed to accept to go,” said Mellgren, “If they couldn’t find anybody else.”
When the team needed another surgeon for just one week of the two-week eye clinic in June, out she flew — 5,000 miles to Majuro, Marshall Islands. And one little boy and his family will be forever grateful she did.
On Majuro, a female patient came to the clinic accompanied by her husband and son — a small and somber boy who stood very close to his father. After the woman was scheduled for her own surgery, she asked whether someone could please remove the cataracts from the eyes of her 6-year-old, Robuti.
The parents were feeling desperate. They had asked other eye specialists, but each time been turned down. Mellgren was not surprised by their refusals. She explained that the tissue of a child’s eye is more flexible than that of an adult’s, and the shape and size of the eye differs also. So pediatric eye surgery is a specialty. “It has to be done right the first time,” Mellgren said.
In his good eye, Robuti’s declining vision tested 2200 (he could make out the second biggest E on the eye chart). In his other eye, he could just distinguish fingers from 2 feet away. Roughly, the boy saw dull shapes and movement, but could not read anything or recognize faces.
“We are not born with sight,” Mellgren explained. “We develop it.” And whatever sight Robuti had begun to develop as an infant had been overtaken by the growth of cataracts. As vision develops in tandem with the brain, sight correction must happen during early years, or a child’s brain will not be able to see, ever. Mellgren knew the window of opportunity was closing; unless Robuti had the operation soon, he would be blind for all his life.

“I knew this was probably his last chance,” said Mellgren. “But I wasn’t sure whether I should try doing the surgery.” She had performed a successful pediatric ophthalmologic surgery once in her career, but it had been many years ago. As Mellgren prayed about it, she also consulted with pediatric ophthalmologist Paul Engstrom, her colleague in Roswell. Dr. Engstrom, after discussing the case with her at length, encouraged her to do it. She decided she would.
But another challenge threatened the surgery. General anesthesia is standard for cataract surgery to make sure the patient does not make any sudden movement during the procedure. However, placing a child under general anesthesia is very risky, and the nurse anesthetist refused to do it. Instead, the child was unconscious only for a brief moment when the nerve block was placed. After that, Robuti was conscious for the surgery. Remarkably, the boy was able to remain still for the entire operation.
“We did his poorer eye first,” explained Mellgren. “And more people than normal, including a videographer, crowded into the operating room. Having so many people watching me certainly added to the pressure I felt.”
The procedure took about half an hour and the eye was covered with a bandage for 24 hours. When the bandages were removed and Robuti could see again, tears streamed down Mellgren’s face and she quickly explained, “I always cry when I’m happy.”
Even before his surgery on the other eye, Robuti was a very different boy than the one she had first met. In fact, Robuti had been so un-childlike he had been nicknamed “old soul” by the eye team members. “When he came back the next day, he was no longer timid or still,” said Mellgren. “He came to the clinic holding a cellphone and ran around taking pictures and videos, just like a normal child.”
Juliane Poirier is communications director of Canvasback Missions.