Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Med Life with Dr. Horton
    • Podcasts
    • Videos
    • Alerts
    • RSS
    • Classified ads
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Activate online account
    • Look up login
    • Earn CPD Credits
    • Members Corner
    • Print copies of CMAJ
  • Subscribers
    • General information
    • View prices
    • Activate subscription
    • Look up login
    • Manage account
    • Manage IPs
    • View Reports
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JPN

User menu

  • Subscribe
  • My alerts
  • My Cart
  • Log in

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JPN
  • Subscribe
  • My alerts
  • My Cart
  • Log in
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Med Life with Dr. Horton
    • Podcasts
    • Videos
    • Alerts
    • RSS
    • Classified ads
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Activate online account
    • Look up login
    • Earn CPD Credits
    • Members Corner
    • Print copies of CMAJ
  • Subscribers
    • General information
    • View prices
    • Activate subscription
    • Look up login
    • Manage account
    • Manage IPs
    • View Reports
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
News

Rare recovery for acid attack victim in Cambodia

Brendan Brady
CMAJ October 15, 2013 185 (15) E714; DOI: https://doi.org/10.1503/cmaj.109-4553
Brendan Brady
Phnom Penh, Cambodia
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Responses
  • Metrics
  • PDF
Loading

Cambodia is among a small group of countries, which also includes Pakistan and Bangladesh, that have a history of acid attacks being carried out as an extreme form of revenge, with the intention to humiliate and debilitate rather than kill.

In 1996, Tes Pha was doused with liquid acid by a woman who suspected Tes was having an affair with her husband. The acid severely damaged much of her face and upper body, and blinded her. Her prospects for recovery seemed limited to preventing further deterioration — scars from acid burns contract, causing further pain and immobility unless they are operated on regularly.

In April, however, in an effort to restore vision in her left eye, the 53-year-old received what is likely the first cornea transplant for an acid attack victim in Cambodia.

Cornea transplants are rare in Cambodia, where the cost of sourcing a healthy cornea is well beyond the average annual salary of most people, organ donor banks are non-existent and surgeons capable of carrying out a transplant are few.

Indeed, her transplant was possible because an Alaska-based ophthalmologist, Kevin Winkle, brought a cornea from the United States and led the operation. He was on a medical mission for Surgical Eye Expeditions (SEE) International, a California-based non-profit group that organizes trips for experienced surgical teams to carry out operations and training in countries where surgical expertise is limited.

Acid attack victims are unlikely candidates for a cornea transplant because the surrounding eye tissue — the limbal stem cells “where the white part of the eye meets the clear window,” as Winkle describes it — required to bind to the donor cornea are usually too severely destroyed for it to be feasible.

“Most of the folks I saw had so much damage and scarring in that area that I had to assume that a graft could not heal and last,” says Winkle.

Figure1

In 1996, Tes Pha was left blind after being doused with liquid acid. But in April an American surgeon successfully performed what is likely the first cornea transplant for an acid attack victim in Cambodia.

Image courtesy of © Brendan Brady

Tes was selected for surgery because she appeared to have sufficient stem cells for the transplant to succeed. But once the operation began, worrying signs emerged, says Soeung Soryoun, a Cambodian ophthalmologist who assisted in the procedure. “We saw there was so much scarring so at first we though there weren’t enough stems cells.”

However, two months after her surgery, her left eye has mostly “accepted” the new cornea and she has regained some vision.

Statistics on acid attacks in Cambodia are unreliable since many cases go unreported. The Phnom Penh-based Cambodian Acid Survivors Charity, a nonprofit group that houses and provides medical care for victims, recorded 12 to 24 attacks annually for most of the past decade (www.cambodianacidsurvivorscharity.org).

Used for clearing drains, agricultural processing and fueling the car batteries that most rural communities rely on for power, acid is widely available in Cambodia. New legislation lengthening prison sentences for perpetrators and regulating the sale and use of acid has dramatically reduced the number of attacks. So far this year, only one case has been reported to the survivors’ charity.

But the legacy of acid attacks remains in the scores of Cambodians suffering in invalided condition and requiring ongoing treatment. The cornea transplant was the third surgery Tes has received in as many years: she only started accessing the survivors’ charity services in 2011; she has since undergone operations to remove contractures on her arm, neck and eyelids. Doctors say she will undergo a third neck contracture surgery once she has recuperated from her cornea transplant.

“There have been many surgeries,” says Tes of her incessant turns on the operating table in recent years. “But I’m now able to work at home — to clean and wash — so I feel much better.”

PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 185 (15)
CMAJ
Vol. 185, Issue 15
15 Oct 2013
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Rare recovery for acid attack victim in Cambodia
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
Citation Tools
Rare recovery for acid attack victim in Cambodia
Brendan Brady
CMAJ Oct 2013, 185 (15) E714; DOI: 10.1503/cmaj.109-4553

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Rare recovery for acid attack victim in Cambodia
Brendan Brady
CMAJ Oct 2013, 185 (15) E714; DOI: 10.1503/cmaj.109-4553
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • Scopus
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Canada’s health system is among the least green
  • Some provinces still delay access to health records via patient portals
  • Nausea-inducing illness caused by cannabis still underdiagnosed
Show more News

Similar Articles

Collections

  • Topics
    • Ophthalmology
    • Global health

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Videos
  • Alerts
  • RSS

Information for

  • Advertisers
  • Authors
  • CMA Members
  • Copyright and Permissions
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact

Copyright 2019, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

Powered by HighWire