Vision Health
(Globe & Mail insert)
There's still a critical shortage of corneas for transplant
Transplantation is offers a 'small miracle' but much more could be done
One of the most successful forms of tissue transplantation needs little more today than additional Canadian donors.
Corneal transplant, explains Dr. William Dixon, co-medical director of the Eye Bank of Canada (Ontario Division), "provides an opportunity for patients to regain their sight or relieve their pain - it's not unlike a small miracle, really."
That miracle is made possible through people's posthumous gift of their eye tissues, readily accomplished through signing a driver's-licence form and alerting family members of that intention.
From the surgeries in 1955 that restored the sight of two Canadian soldiers who had been blinded by chemical warfare in the First World War, the country's first eye bank has performed more than 20,000 operations with donated tissues, most prominently the transparent, protective cornea that covers the iris and pupil of the eye.
By 1996, the Eye Bank of Canada (Ontario Division), started by The Canadian National Institute for the Blind (CNIB) and Canadian Ophthalmological Society, was rated the fourth largest in North America. Today, there are 11 eye banks across Canada.
But there have also recently been transplant surgeries that could not be performed.
"The critical shortage across Canada is due to the increasing need," remarks Dr. David Rootman, medical director of the national eye bank's Ontario division, run by the University of Toronto with the CNIB.
"We've got an aging population, older people are living longer and eye surgery that was a problem 20 years ago can now be done with very good success," he continues. "Over the past 12 years we've seen a doubling of the need from 600 to 1,200 corneas in Ontario alone."
Dr. Rootman describes the cornea as the major focusing lens of the eyes and notes that "any number of processes can cause it to become clouded." "In 2001, there were 2,602 corneal transplants performed across Canada with 3,269 Canadians still on the waiting list," comments Jan Batiuk, public relations person for the Lions Eye Bank Alberta.
Along with cornea-impacting disease that may skew to older populations, young people also often appear with damaged corneas through sport or workplace trauma or, infrequently, through complications from laser surgery to correct vision.
The good news is that corneal transplant in Canada enjoys an overall success rate of more than 80 per cent, partly because these tissues are less vulnerable to the kinds of complications which attend other organ transplant.
"This organ is relatively isolated from the body's immune system, or at least that's what we believe," comments Dr. Rootman, who is based at Toronto Western Hospital.
"In the vast majority of cases, we don't attempt to make a match [between donor and recipient]."
Indeed, even aged donors are often perfectly suitable sources of tissue for those needing corneal transplant.
Virtually all the major religions endorse such donation.
And there is no disfigurement to the body from the rapid surgery that recovers the donated eyes; open-casket funerals are not precluded.
