EYE BANKING -DR.B.KEERTHI

8/9/2019 EYE BANKING -DR.B.KEERTHI

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EYE BANKING



Introduction

It is estimated that approx 190000 persons are blind inindia from bilateral corneal disease and every yranother 20,000 new cases join the existing pool.

According to EBAI statistics, the current corneaprocurement rate in india is 33,000 per year(approx)which is 1/10th of annual requirement.

Corneal transplantation is probably the most successfulof all organ transplant procedures but is dependent onpeople willing to pledge their eyes for donation andeducating others.



Eye bank

Eye banks are conceived to provide

for procurement, processing and

distribution of safe quality donor

eyes for therapeutic use and

research.



und ert akings

Public awareness

Tissue harvesting, evaluation

Tissue preservation and distribution.

C ov ering ar ea Should be able to procure 20 pairs of eyes annually fromShould be able to procure 20 pairs of eyes annually from

an operative population of 2an operative population of 2--3 lakhs.3 lakhs.

Should serve 4Should serve 4--8 eye donation centers covering an area8 eye donation centers covering an area

of 8of 8--15 lakhs.15 lakhs. Should be equipped to meet training related needs of 4Should be equipped to meet training related needs of 4--88

eye banks.eye banks.



Eye bank structur e and f unction

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 chaincontainer

scleral colour

expiry date of storage media



Biomicroscopic examination

Examination of donor eyes before insitucorneoscleral rim excision

A.cornea epithelium edema,exposure,

trauma,FBstroma scars,infiltrations,

ectasias

endothelium KPs,central guttata

B.AC shallow/flat,bld.in

AC,abnormal anat.



C ornea w ith specul ar endotheli al

patt erns un f it f or tr anspl ant ation

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.onendothelium.



C ornea pr eserv ation

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



Ingr edi ents o f pr eserv ation medi a

Dextran essential aminoacidsChondroitin 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

nts

MK KSOL CSM DEXSOL OPTISOL PROCELL

Base

medium

Tc-199 Tc-199 MEM MEM MEM,Tc-

199

MEM

Chondroitin sulphate

Nil 2.5% 1.35% 1.35% 2.5% 1.35%

dextran 5% Nil Nil 1% 1% 1%

Hepes

buffer

Yes Yes Yes Yes Yes Yes

Antioxidants

Nil Nil Nil Yes Yes Yes

Gentamyci

n sulfate

mg/ml

65.5 69.6 67.3 98 99 98

Ascorbic

acid

Nil Nil Nil Nil Yes Nil

Insulin

HEGF

Nil

Nil

Nil

Nil

Nil

Nil

Nil

Nil

Nil

Nil

10 micro

g/ml

10 nano

g/ml

4 days 7 days 7 days 10 days 14 days 14 days



Awar eness o f medical stud ents

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%)



THANK YOU

EYE BANKING -DR.B.KEERTHI

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