Eye Donation and Eye Banking

Question 1

Eye donation

Answer 1

Indications -
a) optical
• pbk
• corneal scarring
• corneal degeneration and dystrophies
• keratoconus

b) Tectonic
• stromal thinning
• descemetocele
• perforated cornea

c) cosmetics

d) therapeutic
• inflammation not responding to therapy

procedure:
- eyes should be closed / patched up after death and fan should be off.
- eyes should be removed 4-6 hours after death in hot, moist, tropical environment, 96 hours in mortuary
- check for death certificate
- fill up consent form properly (through close relatives)
- 10 cc blood is collected for testing
- total remove time for enucleation is 15-20 minutes. if only cornea is required a insitu corneal button is removed
- eye should be placed in a seperate moist chamber after enucleation and later into an eye bag (stored at 2-8°c)
- antibiotics should be instilled and eyelids should be sutured
- appreciation certificate is given to the relatives

c/i for donors
- hiv +ve, active viral hepatitis (hcv), rabies
- htlv -1, htlv - 2, septicemia
- subacute sclerosing panencephalitis
- covid 19
- mucormycosis
- active leukemia

storage
short term (2-3 days) - mk (mc carey and Kauffman), moist chamber

intermediate (7-10 days) - dexsol, optisol

long term (30 days) - organ culture medium, MEM

very long term (1 year) - cryopreservation

evaluation
• biomicrological
• specular microscopy
• microbial evaluation

complications
- flat anterior chamber, iris prolapse, infection, 2° glaucoma, epithelial defects and 1° graft failure

Question 2

Eye Banking

Answer 2

organization which deals with the collection storage and distribution of cornea for the purpose of corneal grafting, research and supply of the eye tissue for other ophthalmic purposes

functions
1) promotion of eye donation by increasing awareness
2) registration of pledger for eye donation
3) collection of donated eyes
4) receiving and processing
5) preservation
6) distribution to corneal surgeons
7) research activities

personnel
1) eye bank in charge - qualified ophthalmologist to evaluate, process and distribute the donor tissue

2) eye bank technician
- eye collection kits ready
- enucleation
- record data
- antibiotics
- corneal preservation and storage
- maintain asepsis in the bank

3) store keeper cum clerk
- maintain records
- coordinate with other banks
- distribute cornea

4) medical social worker / public relations officer
- promotion

5) driver cum projectionist
- maintain vehicle of the bank
- screen films of eye donation promotion

Question 3

eye collection centres

Answer 3

• peripheral satellites of an eye bank for better functioning
• one centre in an urban area with more than 200k population
• 4-5 centres attached to one bank

functions
- local publicity
- registration
- arrangement of collection
- initial processing packing and transportation

personnel
- ophthalmic technician
- ophthalmic surgeon / med officer
- local honorary workers