19 Oct 2008 Oman Daily Observer
 

New eye bank in the offing

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MUSCAT -- So far a total of 135 corneal transplants have been performed in Al Nahdah Hospital. This figure is set to increase manifolds now that "action is being taken to establish an eye bank with dedicated staff trained to enucleate the eyes from the dead bodies, evaluate and preserve them". This was stated by the Minister of Health Dr Ali bin Mohammed bin Moosa in comments to the Observer. He said, "Corneal transplantation is being performed in Oman since 1980. At present, it is a routine procedure at Al Nahdah Hospital.

It is a unique surgery for visual rehabilitation with minimum risk of complications. The success rate of corneal transplantation, depending on the condition of the eye before surgery, is over 95 per cent. It is needed in young patients mainly with congenital corneal deformity and in adults to replace scarred or opaque cornea with a clear corneal tissue". Dr Ali Moosa said corneal transplant is indicated in patients with keratoconus, corneal opacities, corneal degeneration and dystrophy, corneal ulcers and corneal injuries. These are the most important causes of curable blindness; after cataract, in Oman.

The transparent cornea tissue is very thin -- just half a millimetre thick -- and when damaged by injury or disease it can become cloudy or lose its natural shape, both of which can lead to blindness or limited sight. Young people often need a transplant due to a disease called keratoconus, in which the cornea becomes progressively thinner and misshapen, while herpes, the cold sore virus, can also cause scarring if the corneas become infected. The key factor for the success of corneal transplant programmes anywhere is the availability of corneas to be transplanted.

The procedure for corneal donation involves, after a person donates his eyes, enucleation (surgical removal) of the donated eyes or only corneal button from the dead body by well trained staff within six hours of death of a healthy person, followed by proper preservation of the eyes till its use. A ministerial decision, issued in 1993 has legislated the terms of organ donations and has taken all measures to safeguard the interests of deceased donors. Once an Eye Bank is established, actions will be taken to create public awareness through media such that volunteers can pledge to donate their eyes after death and register themselves for such donations in advance, the minister added.

Through publicity and active involvement of community leaders, hopefully, people will realise the importance of organ donation. The current five-year plan of the ministry addresses the problem of corneal blindness. Once the proposed state-of-the-art Eye Bank is set up in Muscat, people suffering from curable blindness would benefit from eye transplant services on a bigger scale and the whole world will be opened up for them again. One donor can restore the sight of two people through a cornea transplant. Cornea transplantation is one of medical world's big success stories.

Corneal tissue can be stored in a special eye bank for up to four weeks before transplant, which helps ensure that donated corneas are available for emergency use as well as for planned operations. Organ transplantation is among the most sophisticated and advanced surgeries. These surgeries are dependent on the availability of the specialised surgeons, technology and the organs to be transplanted. A new cornea can be transplanted in an hour. First, a disc of damaged corneal tissue is removed using a circular cutting instrument called a trephine. This is then replaced by a disc of healthy tissue taken from a donated cornea, and the graft is stitched in place with super-fine sutures, leading to the priceless gift of sight for the sightless.

By Hasan Kamoonpuri

© Oman Daily Observer 2008
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