Year : 1996 | Volume
: 44 | Issue : 1 | Page : 1--2
What is eye banking?
Gullapalli N Rao
|How to cite this article:|
Rao GN. What is eye banking?.Indian J Ophthalmol 1996;44:1-2
|How to cite this URL:|
Rao GN. What is eye banking?. Indian J Ophthalmol [serial online] 1996 [cited 2023 Feb 3 ];44:1-2
Available from: https://www.ijo.in/text.asp?1996/44/1/1/24598
Corned blindness is a major form of visual deprivation in developing countries. A high percentage of these individuals can be visually rehabilitated by corneal transplantation, a procedure that has very high rate of success among organ transplants. Quality of donor cornea, the nature of recipient pathology and the availability of appropriate postoperative care are the factors that determine the final outcome of this procedure.
Procurement and supply of donor cornea to the corneal surgeons is the primary goal of eye banks. While this fact is recognised, the need for rigorous quality control in eye banking is not appreciated by both the eye bankers and surgeons in India and other developing countries. Scarcity of donor corneas, while a major problem, should not lead to utilisation of corneas of undesirable quality, This happens when enthusiasm to start an eye bank is not matched by commitment to institution of quality control measures.
What is ah Eye Bank? An "Eye Bank" is a not for profit community organisation governed by a Board of Directors or Trustees constituted by community representatives. Ideally, it should be autonomous and not part of any medical organisation.
Structurally, it has administrative and medical components. The entire operation is supervised by a Medical Director, who is usually a well qualified corneal surgeon assisted by an Administrator and other staff on the administrative aspects and trained technicians on the medical issues.
Functionally, the administrative section is responsible for public awareness programmes, liaison with government, local voluntary and other health care agencies and fund raising. The medical section deals with the entire technical operation of the eye bank. Tissue harvesting, tissue evaluation, tissue preservation and tissue distribution represent these activities. Each of these should be carried out following medical standards of highest quality. Any deviation from accepted medical standards can result in devastating complications. By definition, only organisations with the above structure and functions are "Eye Banks" and all other are mere "Cornea Collection Centres" (I personally prefer the term "Eye Donation Centres"),
In India, today, we have scores of "eye banks" and only a handful are paying attention to medical standards prescribed. Yet, there is an undesirable proliferation of these so called "eye banks". While there is no need for more than one eye bank in each city, we see the opposite phenomenon across the country. The result is a large number of eye banks with poor standards. On the other hand, if resources in each city can be pooled, it is possible to create eye banks practising the highest standards. The expensive infrastructure to properly evaluate, preserve and distribute donor corneas can be created. This should be our aim. There is no need for an eye bank in each hospital.
An eye bank should have communication facilities, access to equipment such as slit lamp and laminar flow hood, surgical instruments, sterilisation facilities, serology laboratory, preservation media and appropriate transportation system. Round the clock coverage by fully trained technicians is essential. All eye banks should be part of a nationwide network to facilitate optimal utilisation of all corneas found suitable for corneal transplantation,
Networking of eye banks under the umbrella of a national organisation allows better attempts at public education programmes, institution of newer eye banking procedures, training programmes and development of uniform medical standards at significant cost savings for individual eye banks. Ultimately this will increase access to corneal tissue for every person who will benefit from corneal transplantation.
We are fortunate that several well established International Organisations are actively involved in bringing the necessary changes in our eye banking system. Eye Bank Association of India had some initial support from Eye Bank Association of America but over the last 5 years, the contribution of International Federation of Eye Banks has made a major impact in steering our eye banking in the right direction. We often criticise others (politicians) for our woes but here is an opportunity for our profession in India to exploit and put our eye banking on the right track. If we fail to make advances in this field now, it will be hard to find any scapegoats to take the blame.