Eye banking

Introduction
• It is estimated that approx 190000 persons are blind in
india from bilateral corneal disease and every yr
another 20,000 new cases join the existing pool.
• According to EBAI statistics, the current cornea
procurement rate in india is 33,000 per year(approx)
which is 1/10th of annual requirement.
• Corneal transplantation is probably the most
successful of all organ transplant procedures but is
dependent on people willing to pledge their eyes for
donation and educating others.
 Eye bank

Eye banks are conceived to provide

for procurement, processing and
distribution of safe quality donor
eyes for therapeutic use and
research.
undertakings
• Public awareness
• Tissue harvesting, evaluation
• Tissue preservation and distribution.
Covering area
• Should be able to procure 20 pairs of eyes annually from
an operative population of 2-3 lakhs.
• Should serve 4-8 eye donation centers covering an area
of 8-15 lakhs.
• Should be equipped to meet training related needs of 4-
8 eye banks.
Eye bank structure and function
EBs are structured as relative autonomous-
largely voluntary community based with in
built mechanism.
The eye bank association of india(EBAI) has
recommended that
• Each EB should be under the charge of a
medical director/technical incharge.
• He should be a trained senior corneal surgeon.
• He should maintain good communication with
regulatory council, enucleators, eyebank
personnel and public.
• Other key manageal person- eyebank
manager.
• And atleast 3 technicians and grief counselors.
 Equipment for an eyebank
Mandatory Desirable
1.Refrigerator with temp 1.Incubator
Recording device. 2.specular microscope
2.Biological safety cabinet 3.ultrasonic cleaner
3.Slit temp 4.ice machine
4.Sterilization facilities 5.microbiology facilities
5.Enucleaters and corneal 6.centrifuge
Excision instruments.
 Strategies to enhance eye
collection

• Grief counselling
• Publicity
• Operational efficiency
• Legal improvement
 Donor cornea viability: evaluation
methods
• Gross examination.
condition of packing
cold chain
container
scleral colour
expiry date of storage media
 Biomicroscopic examination
Examination of donor eyes before insitu corneoscleral
rim excision
A.cornea epithelium edema,exposure,
trauma,FB
stroma scars,infiltrations,
ectasias
endothelium KPs,central guttata

B.AC shallow/flat,bld.in
AC,abnormal anat.
 Cornea with specular endothelial
patterns unfit for transplantation
• Endothelial cell density <1500 cells/mm2
• Severe polymegathism/pleomorphism
• Presence of central cornea guttata
• Abnormally shaped cells such as fused cells
• Severe edema of endothelium
• Presence of inflammatory cells/bact.on
endothelium.
 Cornea preservation
1.Moist chamber storage
• for storage of whole globe for a short period of
time
• stored at 4 degree centigrade.
Adv: simplicity, requires little expertise& min.
manipulation
Dis.adv: storage time only 48hrs,
• Container is never completely filled with liquid.
2. Tissue media preservation
• Mostly followed method.
• Corneoscleral button stored in culture media
Adv:- Provides chemically defined & stable

environment at 4 degree cent

- Supports and enhance metabolic activities
- Helps to reduce stromal swelling
- Keeps tissue under sterile conditions.
- Provides time for eye bank to serologically
screen donor for comunicable diseases
 Ingredients of preservation media
Dextran essential aminoacids
Chondroitin sulphate antioxidants
Electrolytes insulin
PH buffer system epidermal growtfact.
Antibiotics antiproteases,anticolla
genases.

• Dextran helps to keep cornea thin.

• Chon.sulphate also acts as antioxidant.
• Electrolytes conc. Kept closer to that of AC.
constitue MK KSOL CSM DEXSOL OPTISOL PROCELL
nts
Base Tc-199 Tc-199 MEM MEM MEM,Tc- MEM
medium 199
Chondroiti Nil 2.5% 1.35% 1.35% 2.5% 1.35%
n sulphate
dextran 5% Nil Nil 1% 1% 1%
Hepes Yes Yes Yes Yes Yes Yes
buffer
Anti Nil Nil Nil Yes Yes Yes
oxidants
Gentamyc 65.5 69.6 67.3 98 99 98
in sulfate
mg/ml
Ascorbic Nil Nil Nil Nil Yes Nil
acid
Insulin Nil Nil Nil Nil Nil 10 micro
g/ml
HEGF Nil Nil Nil Nil Nil 10 nano
g/ml
4 days 7 days 7 days 10 days 14 days 14 days
 Awareness of medical students
towards eye donation
Responses
study grp control grp
(n=480) (n=100)
1.Did not know that eyes
To be enucleated within 155(32%) 65(65%)
6hrs after death

2.Had no idea of the structure 192(40%) 70(70%)

Used for eye donation

3.Tried to convince others for 163(34%) 2(2%)

Donation

4.Did not know where to contact 72(15%) 40(40%)

For eye donation
Thank you