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Former Phillies prospect thanks surgeon after life-altering eye injury
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In June 2016, Philadelphia Phillies pitching prospect Matt Imhof was completing a typical postgame stretching routine and workout, using a tension band that was anchored to the clubhouse wall to stretch out his arms.
When Imhof brought one of the bands up over his head, he felt the band lose its tension, sending the metal cleat that anchored the piece of equipment to the wall careening toward his face. The cleat hit him directly in his right eye in the perfect spot to rupture the globe.
Retina surgeons initially were able to repair and restructure Imhof’s ruptured globe, but after several days, his vision did not return and physicians told him it would be advisable to undergo enucleation.
Wendy W. Lee
“Once it was explained to me how bad the injury was when they were trying to reconstruct it, I was already mentally planning for the worst-case scenario. It’s a pretty scary thing when they tell you that you have to have a part of you taken away. It’s a part that is so identifiable — people look into your eyes all the time — so I was scared. I didn’t want to be different — that’s what was the scariest part for me. I thought this entire thing was going to make me into something I’m not. That was a terrifying experience,” Imhof told Ocular Surgery News.
Avoiding sympathetic ophthalmia
Imhof underwent enucleation at Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, and the procedure was performed by Wendy W. Lee, MD, OSN Oculoplastic and Reconstructive Surgery Board Member.
Imhof’s eye had no light perception after repair of the ruptured globe, Lee said, so enucleation was advised in order to avoid sympathetic ophthalmia and pain later in life.
“In situations such as this, we encourage enucleations. If there is no visual potential left in the eye and the injury poses a potential risk to the only remaining good eye, it becomes a nuisance, especially if it starts to cause the patient pain. Through enucleation, we can remove the source of pain and also eliminate the chances of sympathetic ophthalmia while providing better aesthetics for the patient with artistically matched prosthetics. Matt’s enucleation went very smoothly. Occasionally in badly injured eyes the anatomy is distorted, which can make the case challenging. Sometimes muscles are lost or sutures and implants act as obstacles, but we were able to find great dissection planes, isolate all four of Matt’s rectus muscles and attach them nicely to the implant,” Lee said.
Lee successfully implanted a scleral-wrapped porous polyethylene spherical implant into Imhof’s socket. After the surgical site healed, Matt had a prosthesis made that matches his left eye very well. His prognosis is excellent as complications after enucleation are rare.
“The most common issue we see is due to protein buildup on the prosthesis, which can lead to giant papillary conjunctivitis (GPC). GPC presents with discharge and is often misdiagnosed as an infection, but it is not contagious. On the contrary, it is an inflammatory reaction to the protein buildup. In this situation, we recommend patients take out their prosthesis and use enzymatic cleaner to break up the protein that has built up on the surface. In addition, some patients need to be placed on mast cell stabilizers, steroids or antihistamines. It is recommended that patients get their prostheses polished by an ocularist every 6 to 12 months. Other potential complications following enucleation, such as infection and extrusion, are rare,” Lee said.
Lee said Imhof will need follow-up at least once a year to examine his good eye and to make sure there are no problems with the prosthesis or socket. It is extremely important for patients post-enucleation to take monocular precautions, wearing polycarbonate lenses at all times.
A difficult transition
Despite the procedure being a relatively simple one, the transition to daily life after such a surgery can be trying for many patients. Imhof said he was having difficulty facing his new reality and was depressed that his dream of playing professional baseball had come to such an abrupt close.
Lee, he said, told him his injury was “life altering, not life ending,” which helped him gain perspective.
“Those words stuck with me. Maybe my life wasn’t going to go down the path I had planned for myself, but I still had so many great options in front of me and so much to go forward for. She was able to slowly but surely chip away with that message. She explained all the things I still could do. The only thing she said I couldn’t enjoy anymore was 3-D movies, and that’s fine because those are too expensive anyway. We laughed about that. She was so confident that I was going to be OK, and I trusted her because this is her profession. With that, I was able to move forward,” Imhof said.
It is important to provide encouragement and support and let patients know their lives will continue as normal after a transition period, Lee noted.
“Matt has shown tremendous maturity” in facing this traumatic injury, she said, calling him “an inspiration.”
“What I realized from him is how quickly someone like that who had a professional sports career ahead of him could jump back up on his feet, be mature enough to accept what happened to him, make a sound decision and still have a great outlook on life. ... Matt’s kind words touched me as I did not know the degree of impact I had on his life. It validated what I do — the things I do for my patients and the work I put into my career. He inspired me. I am so happy that I was able to help Matt through this very difficult time in his life,” she said.
Imhof re-enrolled at California Polytechnic State University and is on track to graduate in June as a finance/business major. He is also a member of the university’s baseball coaching staff. – by Robert Linnehan
For more information:
Wendy W. Lee, MD, can be reached at Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St., Miami, FL 33136; email: wlee@med.miami.edu.
Disclosure: Lee reports no relevant financial disclosures.