After a Dozen Failed Eye Surgeries, A Patient Finds a Breakthrough Solution at USC

Stephen Singer developed eye conditions in May 2019 when he developed a retinal tear in his left eye. The cause was unknown, but his condition required immediate surgery.

Weeks after the surgery, Stephen’s retina tore again and detached completely. This led to a series of failed surgical repairs that left him with only light perception in his left eye.

In April 2023, Stephen’s right eye developed retinal detachment as well, triggering an exhausting cycle of surgeries. After eight unsuccessful surgeries and other prior surgeries, Stephen’s ophthalmologist referred Stephen to Dr. Sun Young Lee, a retina specialist at the USC Roski Eye Institute.

Dr. Lee first examined Singer in January 2024 and methodically investigated the root cause of Singer’s eyesight. After ruling out multiple possibilities, she suspected an intraocular lens implant from a long time ago cataract surgery was adding complications.

“Mr. Singer is prone to scar formation, a well-known issue among other patients who have undergone unsuccessful retinal detachment surgery due to aggressive scar tissue development, called proliferative vitreoretinopathy (PVR),” said Dr. Lee. “Additionally, there was significant interaction between his intraocular lens from his prior cataract surgery and the silicone oil placed during previous surgeries.”

In April 2024, Lee performed her first surgery on Stephen — the ninth on his right eye — removing the lens implant to effectively clear all the scar tissue that has grown while repositioning his retina. Though the retina detached again due to regrown scar tissues, the surgery gave Dr. Lee a clearer view of the underlying issues.

Dr. Lee cautiously proposed another surgery that required meticulous manual removal of every bit of scar tissue, likely the last possible intervention given his fragile retinal tissue. Dr. Lee also proposed to combine this process with an innovative pharmacological approach, utilizing a recent clinical trial drug Methotrexate (MTX), an anti-cancer medication known to inhibit scar tissue growth.

However, caution was needed due to the potential toxic effects of the drug, which could damage the residual vision. The treatment showed promising results, significantly reducing new scar tissue formation.

“Recent studies have shown that a series of low-dose MTX injections have good rates of retinal reattachment for patients with complex retinal detachment due to PVR. However, many retina specialists are hesitant to use MTX upfront due to its strong toxic effects,” said Dr. Lee. “As a retina surgeon, the most difficult moments are when I must deliver nearly hopeless bad news to patients. The first response is almost always, ‘Why can’t you just fix it?’ Then comes the devastation, especially when the patient has only one eye remaining….”

“Dr. Lee used the term, ‘The odds of success are not zero,’” Stephen recalled. “This was the only hope we had to cling to – extremely slight, but better than my vision fading away completely.”

After the possibly last surgery, Stephen met Dr. Lee every week for over 3 months and it appeared that the amount of scar tissue generated was notably less than prior to surgery. Dr. Lee and Stephen saw this as a small victory, but knew only time would tell whether the scar tissue growth stabilized.

Over the next several months, Stephen developed a full ring of scar tissue around the perimeter, but his retina remained attached.

Six months have passed without Stephen requiring another surgery, a monumental milestone for someone averaging a surgery every six weeks. “This gives me a psychological break. I’m not worried about the next surgery or detachment.”

While Stephen’s vision is still severely limited, he can navigate his home independently and has returned to work part-time after 17 months of remote employment.

“While tremendous loss of vision has altered my life and is clearly upsetting, I am grateful to have a chance to hang onto what little I have left,” Stephen said. “Dr. Lee stopped the progression.”

Stephen is now learning to use adaptive technologies to use a computer and phone without his eyes, and mobility aids like a white cane. Though he can only see large objects at close range and has lost roughly half his field of vision, he is determined to maintain his career where he manages over 100 employees.

“It’s rare for someone like me to keep their employment,” he said. “It’s a long journey to adapt, but I’m making remarkable progress.”

Stephen praised Dr. Lee’s combination of expertise and compassion, noting that she remained realistic about his prognosis while exploring every possible solution. “She does not let the compassion get in the way of telling you what the realities are,” he said. “I am certain she would never agree to perform a surgery that was not merited.”