Jennifer Sanders has spent more than two decades delivering precious cargo around Kansas City and the greater Missouri-Kansas area.
A professional courier, she transports anything that can fit in her car and needs to be moved faster than traditional mail. For the last 15 years, she did it with one good eye.
“I had a traumatic injury back in 2010 that took out 95% of my right iris,” Jennifer said. “Every day I looked in the mirror, I saw what happened to me. Every day, several times a day, I was reminded of the past. I didn’t make eye contact with people at all.”
After doctors stabilized her eye, testing showed that Jennifer’s visual acuity — her ability to see and process the information her eyes were sending — had not been impacted by the injury.
But the near-total damage to her iris, the colored part of the eye around the pupil, meant Jennifer could not control how much light reached her retina and ocular nerve at the back of her eye.
She couldn’t go outside without sunglasses because direct sunlight would give her piercing headaches. Jennifer would wear her sunglasses indoors when picking up or delivering packages to save herself from stares and questions.
“I just expected that I would never see well again,” Jennifer said. “That's what I was told. There was never any hope. At one time, they entertained an artificial lens, but without an iris, it really doesn't do any good.”
But during a routine eye appointment in 2023, Jennifer’s optometrist told her about a procedure that had emerged years after her injury: An artificial iris transplant.
Excited, Jennifer went home and looked into ophthalmologists nearby who offered the surgery. One of them was James Landreneau, MD, at MU Health Care’s Mason Eye Institute two hours away in Columbia.
“Lots of people have left eye appointments after being dilated, and your day is kind of ruined,” Dr. Landreneau said. “Or you’ve been in a movie theater, and someone opens the door and that light is so bright you can’t see the screen. For Jennifer, it was like she was dilated permanently with the lights on, but as soon as you remove that distraction, her vision was 20/20.”
That vision test was part of a full-scale evaluation of Jennifer’s right eye by Dr. Landreneau and his team. He told her she was an ideal candidate for the surgery.
“I can't even explain how exciting that was, just to get confirmation that I was the perfect candidate for it,” Jennifer said. “Waiting for the surgery, those were the slowest days of my life.”
Dr. Landreneau took scans of her healthy left iris, which included information about the color, shape and size, to send to the prosthesis manufacturer in early 2024. It takes five to 12 months to create, and Jennifer had her surgery in September of that year.
“Jennifer’s case took time to plan, because even though I and others have successfully performed this surgery elsewhere, she was the first at MU Health Care and the first in Missouri,” Dr. Landreneau said. “Insurance and state-based medical regulations are part of that, but I’m excited because it just means that these will become easier to approve and pay for. Jennifer was the perfect patient, because there was no other procedure that would have given her this kind of outcome.”
As a courier, Jennifer has transported everything from paychecks and important legal documents for businesses, to medical tissue for donor networks like the Midwest Transplant Network, including deliveries to MU Health Care. She never expected that one day someone would hand deliver a new iris to Dr. Landreneau for her.
Once the iris had been created, Dr. Landreneau used tiny surgical implements to place the iris, as well as a new artificial lens, in the right place. Then he sutured the new iris and lens to the outside corners of her eyes to keep them in place.
“Dr. Landreneau is great,” Jennifer said. “From what I'd heard about him, he is one of the best cornea doctors. I wasn’t nervous at all — I was excited for this.”
Because the procedure is so new, parts of it are not covered by insurance, though Jennifer and Dr. Landreneau are both hopeful that successful stories like hers will help change things. Jennifer took out a loan, and is raising money on GoFundMe, to pay for the artificial iris.
“Out-of-pocket costs are a huge hurdle, and I hate bringing up money with patients, but it is a big part of it,” Dr. Landreneau said. “I've written our state representatives a few times about it, because there's many patients who have no other option.”
The new iris has an opening set at a fixed diameter, what Dr. Landreneau calls the pupil’s resting state. This opening greatly reduces the amount of distracting light that enters Jennifer’s right eye and helps with glare, dilation and the discomfort of being outside in the sun.
In the years between injury and treatment, Jennifer’s right eye moved out of alignment with her left, a condition called eye drift. Her care team at MU Health Care, including Tricia Fernandez, MD, helped treat and improve.
“For Jennifer to fight through this for more than a decade really speaks to her will,” Dr. Landreneau said. “Her improvement has really been remarkable. Every time I've seen her in the year since her surgery, her uncorrected vision and eye drift are improving. It gives me chills thinking about how much this has helped her. It’s been one of the most rewarding cases of my entire career.”
For Jennifer, the vision improvement has almost been surpassed by the cosmetic improvement.
“I’d almost forgotten what it was like to have eye contact with people,” she said. “I feel a little more human. People aren’t staring at me all the time. I can look in the mirror every day and not see what happened to me. Because of the trauma of my injury, to have something good come out of a bad situation is awesome.”