Getting His Life Back

Published in Wilmer - Summer 2023

Don Kalil began noticing a change in his vision in the spring of 2021. By the end of that year, he couldn’t drive. Then a few months later, while on vacation in Italy, “I realized I couldn’t walk without having somebody by my side,” says Kalil. “Eventually, I couldn’t cut my own fingernails. I couldn’t go into the refrigerator and recognize what was in there to eat. It was pretty bad.”

Kalil was no stranger to vision challenges. The difference this time was the severity of his vision loss.

In 2002, when he was about to have LASIK eye surgery, Kalil’s ophthalmologist noticed he had high pressure in his left eye. He was diagnosed with glaucoma and underwent multiple surgeries to bring down the pressure. In 2011, he had cataract surgery to replace his cloudy lens. But a few months later, Kalil’s vision was worse than ever. He felt like he was looking through a spoonful of petroleum jelly in his left eye. He began to search for a place that could help him maintain sight in his right eye and perhaps even regain sight in his left. In 2012, that search led him to the Wilmer Eye Institute.

At Wilmer, he had four corneal transplants, several surgeries for glaucoma, removal of a cataract and interventions to address swelling in the retina. His eye conditions are complex, and he has a team of three Wilmer ophthalmologists — specializing in cornea, glaucoma and retina — working together to address his various diagnoses.

“Glaucoma has been Mr. Kalil’s primary problem. It has caused the need for surgeries, which has caused his corneal issues and his retinal issues,” says Pradeep Ramulu, M.D., Ph.D.chief of the Glaucoma Division and the Sheila K. West Professor of Ophthalmology. “On the one hand, we can’t let his pressure get too high or he could lose his vision to glaucoma. But at the same time, the things we do to control the pressure risk other parts of his eye. We’ve been fortunate to be able to manage these problems together as a group.”

“Having three different doctors at Wilmer is an advantage because we communicate quickly, and we’re able to perform diagnostic testing from all three points of view,” says Mandeep Singh, M.D., Ph.D.a retina specialist and the Andreas C. Dracopoulos Professor of Ophthalmology, who collaborates with Ramulu and Esen Akpek, M.D., a cornea specialist and the Bendann Family Professor of Ophthalmology, to provide Kalil’s care.

Kalil’s conditions were managed well enough that he and his partner, Susan Melis, were able to pursue an active lifestyle. Since his retirement in 2017, they have had close encounters with buffalo, cougars, elephants, giraffes and lions while on safari in Kruger National Park in South Africa; hiked up hundreds of steps in the tight quarters of ancient pyramids in Egypt; and toured Italy, from the striking blue waters of the Amalfi Coast to the lemon and orange groves of Sorrento.

By 2020, however, Kalil had developed a cataract and high pressure in his right eye. To address this, Akpek performed cataract surgery. During the same session, Ramulu placed a stent to create a path for the fluid to drain to address the elevated pressure. A year later, Ramulu also performed surgery to place a tube in the eye that would drain excess fluid to a reservoir outside of the pressurized portion of the eyeball. Throughout this time, Singh used medications to treat Kalil’s retinal swelling caused by inflammation and eye pressure fluctuations. After these interventions, Kalil could see out of his right eye — that is, until his right cornea failed.

And that was the ultimate cause of his noticeable vision decline in 2021. “That trip to Italy, I thought that was it, that I was done traveling. There was a lot I wanted to see and do, and I couldn’t,” says Kalil. He and Melis canceled a 10-day cruise on the Danube River in Europe that they had been planning for nine months.

“Our life changed pretty drastically and very quickly,” says Melis. “We just began to focus on helping Don get through a day safely. He had a very hard time with spatial perception, for example. I painted ladybugs on the concrete steps outside so that Don could see from one step to the next.” They curtailed many activities, from bike riding to traveling.

Kalil describes Melis as his “eyes” during this time, and they both emphasized the importance of retaining their sense of humor and hope for the future — hope based on consultations with Kalil’s specialists at Wilmer.

“Dr. Akpek had a plan,” says Kalil. He would need a partial thickness corneal transplant in his right eye. But first, Akpek wanted to address his left eye. “I at least wanted to get him somewhat better vision in his left eye so he could function and take care of the right eye and himself after surgery,” she says.

By this time, Kalil’s entire left cornea was failing: He would need a full thickness corneal transplant. He was prescribed immunosuppressants to decrease the possibility that his body would reject this third corneal graft.

After Kalil was on the medication for three months, Akpek could perform the full thickness corneal transplant. During this procedure, the entire cornea is removed and replaced with a donor cornea. Several weeks later, she performed a partial thickness corneal transplant on Kalil’s right eye. During this procedure, Akpek removed the inner lining of the cornea, then replaced it with donor tissue to restore vision.

Today, Kalil is in a good place with his vision. He can read and drive again. He continues to take immunosuppressants along with steroid eye drops to prevent his corneal transplants from failing. He will also soon get a contact lens to help improve the vision in his left eye, a common next step after a full thickness corneal transplant.

“It was life changing — to be able to do almost nothing without help to now being able to legally drive and travel and get back to my projects and the things that I love,” says Kalil.

He and Melis are also looking forward to their first big trip since his eyesight has been restored: a cruise through Switzerland, Germany and the Netherlands. About his patient experience at Wilmer, Kalil says: “The doctors truly care about you as a person. They gave me my life back.”