Around 56 per cent of the cornea donated every year across the country is not used for transplantation in some other person. With national average of this utilisation to be just 44 per cent, the rest is considered unfit for use, suggest national eye banks.
Dr Jeewan S Titiyal, Chairman, National Eye Bank (NEB), All India Institute of Medical Sciences (AIIMS) said, "Cornea is a tissue. If we take100 tissues, only 40-45 are considered good to be transplanted in a person waiting for surgery. The national average is 44 per cent. The rest is not considered suitable for the transplantation."
Similarly, Dr AK Grover Director, Rotary Delhi Central Eye Bank, Sir Gangaram Hospital said, "In our hospital, we are generally able to use only 50 per cent of the total cornea retrieved because half of the cornea we get is not suitable for use." This year the bank has received only 50 corneal tissues so far, Dr Grover said.
According to the doctors, the eye banks across the county get the tissues that fail to be considered good optical quality tissues. "In most of the cases of voluntary donations, the age of the donor is above 60 years. There the utility is less. The utilisation of these tissues is just 40 per cent," said Dr Titiyal.
"Tissues which are transplanted in another person have to be clear and viable which is not possible in most of the cases."If the donor suffered from cancer, HIV, diabetes, viral infections or other such diseases before death or there is some problem in the structure of the tissue, then the tissue cannot be used for transplantation," said Dr Grover.
The shelf life of a corneal tissue is just 7 to 8 days and that too after it is kept in a preservative medium and as the days pass, the quality further deteriorates, they said.
When asked about the tissues that are not used for the transplantation, Dr Titiyal said, "We use these non-suitable tissues for training purposes. We have to train people. How would somebody learn surgery?"
According to Dr Grover, "We have a research team that conducts studies on these non suitable corneal tissues. Also in cases where the donor suffered from any disease, these are the eyes used for experimentation and research."
Interestingly, according to the data released by NEB, around 70 per cent of the cornea retrieved by Dr Rajendra Prasad Centre for Opthalimic Sciences (RP Centre), AIIMS is used for transplantation. As per the data, in 2017, NEB made the record corneal tissue collection of 1844 out of which, 1285 tissues were transplanted. The NEB since its inception has received 26000 corneal tissues and has transplanted more than 17000 tissues.
"At RP Centre, we do not transplant the tissues to just cure the blindness but sometimes there are cases where there is some infection in the eye, in such cases, we do not want a good quality tissue. There, we just have to save the eye, so these tissues are used there," said the doctor. This is how around 70 per cent of the retrieved cornea is utilised, added Dr Titiyal.
Shockingly, in India, around 2 lakh patients are waiting for corneal transplants and every year 40,000 more patients get added to the waiting list, said the doctor. The country is way behind the actual requirement of surgeries per year, he added.
"The country needs around 1 lakh surgeries per year, however, only 26000 surgeries were performed last year.
In RP Centre alone, we have 560 patients waiting for the corneal transplants," said Dr Titiyal.
Doctor Titiyal also informed that India at present has only 300-400 transplant surgeons however there is a requirement of at least 1000 surgeons to perform 1 lakh surgeries every year.