Aging brings loss of vision due to loss of transparency in the crystalline lens of the eye and the condition is known as Cataract. No medicine can cure it, so surgery to remove the opaque lens and replace it with an artificial lens is the only remedy.
With the advent of microscopes and phaco machines, cataract surgery has become a miracle bringing great visual results.
But surgery has its own challenges. Here, we as surgeons are afraid of infection leading to endophthalmitis and the second is intraoperative drownings of the crystalline lens in the vitreous chamber. Either of the two complications can lead to visual damage and phthisis - softening of the eyeball to the shrunken small eye. So though results are the best most of the time, it cannot be so each and every time and complications can occur.
What are the expectations of a cataract patient going for surgery?
Though this may sound to be a simple question, the answer is a bit complicated. I will start from the expectations. one by one from the maximum to the minimum.
- I should have the best possible visual outcome at the earliest without any pain, redness, or swelling.
- I will tolerate some pain and redness, but I should gain vision to some extent if not the best.
- Cosmetic: By chance, if something goes wrong during surgery for reasons beyond the control of the surgeon despite the best care, my eyeball should remain in shape and I should not have a deep shrunken eye.
- Painful blind eye: At least, I should not have an eye causing constant trouble like pain, watering, and irritation. I may tolerate small eyes (phthisis).
- Life-threatening complications: As time passes, I will accept ocular complications as my bad luck, but I should not die in the operation theatre due to a reaction to any injected drug or cardiac arrest. At least I should go home alive.
These are the thoughts I had myself while my cataract surgery was going on.
We, the eye surgeons operating thousands of patients during our lifetime and having complications at least a few times are not happy passing through such events. Being sensitive, we may become stressed and sometimes lose sleep for many nights.
Maybe we see this thought cycle of a patient and learn about the other side of the story - the patient.
Dr Bhaharchandra M. Desai
M.S (Oph)
What is a cornea and how do cornea transplants restore sight?
The cornea is a clear dime-sized tissue that covers the front of the eye. If the cornea becomes clouded through disease or injury, vision is impaired and sometimes lost entirely.
The only substitute for a human cornea is another human cornea donated at death by someone who thus leaves a living legacy.
Who can donate eyes?
Almost everyone can donate his or her eyes. Donor tissue that can’t be used for transplant can, with consent, be used for medical education and research purposes.
How can I donate my eyes?
There are two very important steps you must take to become a donor. First, sign a donor card and carry it with you. Second, TALK TO YOUR FAMILY. You must let your family members know that you wish to be an eye donor. Unless your donor card is available at the time of death, your next of kin will be responsible for granting consent. It can be a difficult decision for them if your wishes are not known. Having a discussion about donation with your family is the first step in the effort to restore sight and save lives.
Is there a cost to donate?
There is no cost to donate. Transplant agencies pay any costs associated with the recovery of organs and tissues from donors.
Would donating delay funeral arrangements?
Donating should not delay funeral arrangements. It may take additional time, usually no more than four hours, to coordinate the donation process with the funeral home, and for any extra efforts taken to prepare the body for presentation.
Can we have an open casket?
Eye donation should not prevent having an open casket service.
Does my religion support eye, organ, and tissue donation?
All major religions support donations. However, if you have concerns about your religion’s position, please get in touch with your religious leader/representative.
Is cancer a rule-out for donation?
No, cancer does not automatically prohibit eye donation.
If I wear glasses can I still donate?
Yes, you can! People who have poor vision and wear glasses, or have had previous eye diseases or surgery can still donate, since these conditions may not affect the cornea. Eyes donated to The Eye Bank that are not medically suitable for transplant may be used for medical research and education. For example if you have had LASIK surgery you can donate for research and medical education purposes.
Are families told who will receive the donation?
It is Eye-Bank policy to keep donor and recipient identities completely confidential. However, certain information can be shared and The Eye-Bank offers to conduct correspondence between donor families and recipients as long as identities are kept anonymous. Recipients especially are encouraged to send thank-you notes to their donor families through The Eye Bank. Click here to learn how to write your donor family.
Can the family designate a recipient?
It is possible to designate a recipient although it is fairly unlikely that a donation would occur in a timely manner to facilitate a needed transplant. However, if at the time of death, a family member is in need of a cornea transplant then The Eye Bank will make every effort to match the donor tissue with that person.
What kind of research is done with eye donations?
Research into diseases such as cataracts, glaucoma, and diseases of the retina is advanced through eye donation. Read more about our research efforts in our Research section.
How long do recipients usually wait for a cornea?
Cornea transplant surgery is typically an elective procedure allowing the surgeon and patient to choose the most convenient day for the surgery to take place. The need for emergency tissue is met within 24 hours.
How long can a cornea be stored?
The Eye Bank does keep a “bank” of tissue in its laboratory. Fortunately, cornea tissue can be preserved and stored for several days before it must be used for transplant. However, since the demand for ocular tissue is so great most donor tissue is distributed within a day or two after its arrival.
What happens to unused tissue?
Tissue not used for transplantation or research is disposed of in an ethical manner.
Reference: EyeDonation.org
