Many hundreds of corneal grafts taking place annually in South Africa, the need for which continues to increase.
Corneal transplantation, also known as corneal grafting, is a surgical procedure where a damaged or diseased cornea is replaced by donated corneal tissue (the graft). When the entire cornea is replaced it is known as penetrating keratoplasty and when only part of the cornea is replaced it is known as lamellar keratoplasty.
What is recoded below is a snapshot of the process undertaken to ensure that the donor cornea is harvested and delivered to the surgeon timeously for the graft to take place.
The graft co-ordinator is contacted by a hospital to notify them of the passing of a donor patient. The medical history of the donor patient is reviewed to confirm that the donor cornea is suitable. Anyone can become an organ donor . Persons under the age of 18 require parental permission. The exclusions are as follows: positive virology results for infectious diseases such as HIV/AIDS, Hepatitis B or C, septicaemia, previous ocular tumours and those in which possible COVID- 19 has not been excluded.
The co-ordinator has approximately 12 hours to harvest the cornea. It is often a difficult time to approach the family and the co-ordinator needs to be sensitive when discussing donation with the family, where organ donation has not been previously consented to.
Donated tissue is procured by trained personnel who work for the Eye Bank and this takes place at the hospital or funeral home. The process of recovering the tissue takes approximately 30 minutes. Great care is taken to preserve the appearance of the donor. The tissue recovery does not compromise funeral arrangements.
The tissue is carefully stored in preservation media and transported to the Eye Bank where it is placed in a temperature regulated fridge. The tissue is evaluated for infections and imperfections before being issued. Less than 1% of corneas previously donated to the Eye 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.
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.
The gift of sight is usually made anonymously but the recipient family can write a letter of thanks to donor family.