Procurement, storage and utilization trends of eye banks in India

Abstract

Purpose: To study the trends in collection, storage and utilization of donor corneas in eye banks in India. Methods: The data was collected from 12 eye banks in India that collected more than 1000 corneas per year. The retrospective analysis of the parameters like characteristics of the donor and the host, storage media used, number of eyes collected, number of eyes utilized, causes of non-utilization of the tissue and the procedures performed was done. Results: A total of 20,564 eyes were collected by the 12 eye banks during the year 2013–2014. Voluntary eye donation (VED), and hospital cornea retrieval program (HCRP) contributed to 59.6% and 40.4% of tissue procurement respectively. Whole globe enucleation (52.3%) was more commonly performed as compared to in-situ excision of the donor corneas. The most commonly used storage media at all eye banks was McCarey-Kaufman (MK) media (83.3%). The utilization rate of the donor eyes was 50.5%. The most frequent indication for corneal transplantation was infection (active infection - 33.13%, healed infection - 10.78%) followed by Pseudophakic bullous keratopathy (PBK) (13.57%). Full thickness keratoplasty (optical penetrating keratoplasty - 47.23%, therapeutic penetrating keratoplasty - 31.74%) was performed most often followed by endothelial keratoplasty (12.41%) in the developing country. Conclusion: VED still contributes to majority of the donor tissue retrieval in India. The majority of the eye banks still utilize whole globe enucleation technique and store tissues in MK media. Trends from previous years showed a change towards HCRP, in-situ excision technique and preservation in the long-term storage media.

<p>Donor Profile, Tissue Evaluation and Comparison of Voluntary and Motivated Corneal Donation in Nepal Eye Bank</p>

“…[3][4][5] Some eye banks in India rely mostly on home deaths with collections from 71 to 75.2% of the tissues. [6][7][8] In our study, all HCRP donors (87.7%) were within 10 kilometers of the eye bank (Table 1) unlike in the study of Desar et al, where the distance to travel to get corneas was more than 60 km in one third of the donors. 6 NEB is in a favorable location, which is an advantage for shorter tissue excision and preservation time.…”

“…There has been male preponderance in many eye banks (57 to 68%). [4][5][6]8,10,12,13 This could be because cardiovascular diseases and trauma were important causes of donor deaths in most eye banks, which could have occurred more in the male gender, like in our study ( Table 2).…”

“…In India, most eye banks use MK media followed by Cornisol and Optisol media (Bausch and Lomb, St Louis Missouri). 3,8 Longer term storage media like organ culture is used in New Zealand. 10 NEB has trained EDCs and ERTs who thoroughly screen the donors for any contraindications and also carefully examine the tissues prior to harvesting them.…”

“…97% of transplantable tissues were used for surgery in our eye bank, compared to 88% reported by Cunningham et al 10 In India, utilization rate in various eye banks varied from 50.5% to 75%. 3,8,15 NEB distributes tissues to surgeons within the country on a fair and equitable basis. They can get tissues from NEB without much waiting time.…”

World’s Largest Eye Bank has Served a Nation for Three Decades

“…In India, although the transplant rate for hospital retrieval is about 50%, [3] for home retrieval, it varies between 22 and 28%, as most voluntary donations are recovered to honor the wish of donor family and avoid discouragement and disappointment.…”