Health Administration Ludhiana is celebrating eye donation fortnight from 25th of August to 06 of September 2007. There is a unique sociological aspect of eye donation. Someone can see this colorful world through your eyes even after your death. You can enrich a visually impaired individuals life, a precious gift without costing you anything. Yet there are far few people enlightened enough to understand this. Precious graftable tissues continue to be burnt away after the death of individuals. Simply pledge your eyes and live after death. Yet like any other noble cause, this cause also needed protection from exploitation by unscrupulous elements of our society. Human Organ Transplantation Act (HOTA) was framed with a broader view to curb unethical tissue transfers. Ethical requirements of corneal transfer demand that the identity of the donor should not be disclosed to the recipient of the tissue and there should be no money involved. Any financial transaction in tissue transfer out rightly amounts to sale and a criminal offence. However a surgeon doing corneal transplantation surgery has the right to ask for a reasonable operative fee. Operating surgeon has to be a qualified Ophthalmologist. Surgery has to be conducted in Hospital Operation Theatre and the Government of India has banned all kind of outdoor surgeries including corneal transplantations in field make shift operation theatres. Most suitable donors for corneal tissue transfers are the unfortunate youngsters who lose their life in accidents and the best time for tissue transfer is within six hours after death but in hot and humid conditions it can be as short as 2 hours. Time minimized between the tissue retrieval and grafting vastly improves the results. The critical determinant of graft suitability is endothelial cell count of the graft but unfortunately determination assays for endothelial cells are generally not available at most of the places.
Most of the eye banks are in fact eye collection centers equipped at the most with refrigerators. Retrieval of corneal tissue from a dead person is not an offence unless the person has openly declared on a public plat form that his eyes should not be removed after death. Earlier position on the subject was that a person had to pledge his cornea and the relatives gave the consent for retrieval of corneal tissues after the death of individuals. This proved to be an impractical idea and the pledge forms were not found at the time of need. Removing corneal tissue from dead does not constitute mutilation in any way and it is not prohibited by any religion. In fact Buddhists advocate organ donations after death. Sri Lanka with majority Buddhist population was the main donor location and Madras the main recipient destination. Specialist Surgical Centers evolved at a fantastic pace in South India and until only a few years back eye donation movement had gained momentum but the emerging technologies and stringent laws halted this movement in its tracks. Inherently poor and unpredictable clinical results consumer right awareness, stringent laws, privatized market forces driven health care system all became obstacles for the eye donation movement.
Now at present we are left with a few corneal transplantation centers and far few corneal transplantation surgeons. At community level, the incidence of the corneal opacification the main indication for corneal surgeries can be reduced by preventive measures in school gong children. Still it is not only the corneal opacity that requires corneal transplantation but countless other clinical entities like perforated corneal ulcers, viral corneal disease, industrial accidents, thermal and X-ray irradiation induced damages, congenital deformities etc. Corneal grafting is a procedure getting relegated to backstage but we definitely need to take corrective steps to salvage this situation.
Dr. Capt. Pardeep Sharma
Oral and Maxillofacial Surgeon
Programme Officer
O/o Civil Surgeon
Ludhiana
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