Useful Information for
Potential Cornea Donors & Donor Families
The cornea is a thin, clear layer of the eye that covers the iris (the coloured part of the eye) and the pupil. It looks just like a contact lens and it is the size of a 1 cent piece. It is a vital part of the eye. Light first penetrates the corneas, becomes focused by the lens, and is then projected onto the retina where the stimulation becomes interpreted as a visual picture by the brain. Should the cornea become cloudy from disease, injury or any other cause, vision will become dramatically reduced and sight can be lost. Severe damage of the cornea also impairs the protection of the eye from the drying environment and from infection.
A corneal transplant is a delicate, micro-surgical procedure that replaces a disc segment of an injured or diseased cornea with a similarly shaped piece of healthy donor cornea.
Adults, children and even babies need transplants for a variety of reasons.
A transplant may be necessary because of cornea failure due to:
- Hereditary problems such as Fuchs’ dystrophy or keratoconus (thinning and steepening of the cornea).
- Scarring after injury, ulceration or infection.
- Ageing processes may affect the clarity and health of the cornea.
- Corneal disease.
Despite many hundreds of corneal graft surgeries taking place each year in South Africa, the need is ever increasing and unfortunately never satisfied.To date, the use of artificial materials for corneal transplants has been unsuccessful. As a result, patients awaiting corneal transplants depend solely on the gift of tissue donation. If you choose to donate the whole eye instead of the cornea alone, the white of the eye (sclera) can also be used in other types of eye disease.
Sight is essential to the normal daily functioning and holistic life experience of an individual. Performing your occupation, caring for children or learning at school requires the precious sense of vision for its effective and positive achievement. Every year, more than 150 people in KZN have their sight preserved or restored through corneal transplantation. In addition to the cornea, the sclera (white part of your eye) can also be donated and used for ocular graft surgery in the treatment of cancer, trauma and other diseases. One eye donor can help up to 6 people through transplanted tissue. Today, corneal transplant surgery is the most frequently performed human transplant procedure and has a success rate that exceeds 90%.
Yes, the time limit after death is 12 hours in which the Eye Bank staff need to procure the donated corneal or eye tissue.
The process of recovering the tissue and ensuring the optimisation of the appearance of the donor takes approximately 30 minutes. Arrangements for this tissue recovery do not compromise funeral arrangements and the Eye Bank staff will usually liaise with the funeral home or hospital in this regard.
A corneal transplant is usually performed within 1 to 10 days after donation, depending on the completion of testing, the location of the receiving hospital and the preparation of the selected recipient.
Any person between the ages of 6 and 70 years who has died following either natural causes (e.g.: heart diseases, most cancers, strokes) or unnatural circumstances (e.g.: car crash injuries, gunshot wounds, stab wounds). Cataracts and poor eye sight do not prevent eye donation, however, previous lazer surgery to the eye and infections such as TB and HIV as well as lymphoma and leukaemia are unfortunately contra-indications for donation. The Eye Bank staff may ask the next of kin, as well as the potential donor’s doctor for information on the health status and circumstances surrounding the death of the deceased, in order to determine whether the tissue may be suitable for donation.
The gift of sight is usually made anonymously. Specific information about the donor or donor family is not generally available to the recipient. However, the eye bank does encourage recipients to write a letter of thanks to the donor family, which will be forwarded on by the staff. The Human tissue Act does, however, make mention of an option for the two parties to meet, if donor and recipient parties both agree and apply in writing to the Eye Bank.
All donors and corneas are carefully evaluated. Less than 1% of corneas previously donated to the bank have been deemed unsuitable for transplant. In the unlikely event of this occurring, the Eye Bank has a policy regarding the medical discarding of tissue through an established hospital procedure.
Currently, it is against the ‘Human Tissue Act’ (which is a law that regulates practises relating to human tissue and organs within South Africa) to pay a donor family for donated tissues or organs, as this may be seen as a form of coercion. Donor families will not pay to donate tissue, nor should they be affected financially by doing so. Any costs associated with cornea or eye donation are absorbed by the eyebank. If you have any queries in this regard, please do not hesitate to ask the Eye Bank staff.
Yes. Great care is taken to preserve the appearance of the donor. Following donation, it is very difficult to notice that anything looks any different. Any funeral option is available to the family, including a viewing. Donor families are encouraged to discuss their funeral arrangements, times and circumstances with the Eye Bank staff in order for wishes to be respected and adhered to.
All tissue donated to the KZN Cornea & Eye Bank remains within South Africa for transplantation. On rare occasions, when an urgent case presents in another South African province where the local Eye Bank is unable to service the need timeously, the KZN Eye Bank may consider requests to assist that region. Naturally, this reciprocal arrangement may in turn be called upon to assist critical requests for eye tissue for our local KZN recipients, should the need arise.
Donated tissue is procured by trained personnel who work for the Eye Bank. Thereafter, it is carefully stored in preservation media and is transported to the Eye Bank where it is placed in a temperature regulated refrigerator. The tissue is then evaluated for infections and imperfections before being made available for recipient selection and allocation, with the assistance of an evidence based computer allocation process. The tissue is then transported to the requesting hospital in a controlled environment with tracking procedures to ensure its safe arrival. Naturally, this process involves utilising sterile, disposable consumables, employing professional staff and possessing the necessary refrigeration and support resources for the efficient operation of the service. As a result, a fee is levied for the tissue in order to cover costs and ensure the development of the Eye Bank, which is an essential and community driven health care resource within the province. Patients receiving grafts and transplants within state hospitals receive tissue that is paid for by that state hospital. Private hospital patients belonging to medical aid schemes receive tissue that is usually reimbursed by the scheme.
Most people donate organs and tissue out of an altruistic desire to help another human being. It has been reported by donor families that the pain is often eased, knowing that part of that person can continue to help another person lead a better life.
Most major religions support organ and tissue donation and consider donation as a great and generous gift to the community. Others leave the decision entirely up to the individual without concerns of going against the church’s teachings.