Retinal breaks in eye bank eyes.
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29 pairs of same-donor human lenses were incubated 6 h in radioactive leucine. The accumulation (CL/CM) and incorporation (cpm/mg protein) were measured. Donor ages were 4-86 years old. The total storage time was recorded. Same-donor (mated) pairs gave highly concordant results for the two members of a pair but there was extreme variability between different pairs, even when the age was comparable. Storage time did not appear to be a significant factor during the first 24 h but beyond that time continued storage led to marked deterioration of lens metabolism. Because of high variability, no significant dependence of metabolism on age was apparent. A consideration of these results along with comparable investigations from the literature leads to the conclusion that differences among individuals are the chief cause of the wide variation among human lenses although there is some evidence that storage conditions may produce a significant effect. It was not possible to derive a normal value for the parameters measured in this investigation.
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The International Eye Bank in Bratislava has assembled during its two-year activities 1007 corneae with a 2mm scleral margin by excision performed in the donor in situ, 11 total eye-balls and 43 sclerae. From this total number 1331 eye tissues had to be eliminated because of serum positivity (115 HBsAg, 12 HCV, 2 HIV 1,2 + HCV + HBsAg, 2 HBsAg + HCV, 2 HIV 1.2 + HBsAg). The most frequent cause of death in donors of corneae were carcinomas, injuries and cerebro- and cardiovascular diseases. Corneal grafts are stored at a temperature of +2 degrees C to +6 degrees C in Optisol GS medium. The most frequent indication for keratoplasty in Slovakia was keratopathia bullosa (28.6%), keratoconus (23.9%) and leukoma corneae (18.7%).
In the rabbit, cryoextraction of the lens and subsequent storage in Tyrode's solution did not alter the Na,K-ATPase activity from that determined in immediately excised rabbit lenses. Similarly, the procedures employed with the rabbit eye to simulate collection and storage of normal human eyes (eye banking) had no effect upon the Na,K-ATPase activity of the lens. These results permitted the investigation of human lenses with the knowledge that measured Na,K-ATPase activity had not been altered grossly by any manipulation procedures. Analysis of Na,K-ATPase activity in 44 eye bank lenses, 14 primary nuclear cataracts, 11 primary cortical cataracts, 18 primary posterior subcapsular cataracts, and 31 mixed cataracts revealed no significant difference in the enzyme activity between these groups. Similarly, there was no correlation between electrolyte levels and Na,K-ATPase in a further 18 mixed cataracts. It is concluded that, despite an often pronounced electrolyte imbalance, human cataract can develop without significant alteration in Na,K-ATPase activity.
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Removal of the globe and associated structures has been advocated for tumors invading the periorbital bone and periosteum, orbital fat, or extraocular muscles. In some patients with cancerous tumors encroaching on the globe, however, it may be possible to remove the tumor and save the eye. Tenon's fascia is a firm fibrous sheath surrounding the entire globe except the cornea. If the neoplasm spreads along fascial planes rather than through them, and if this layer remains free of tumor involvement, preservation of the globe can be considered. Oculoplastic reconstructive techniques may limit exposure and diplopia, allowing the eye to be "banked" in vivo, and saved as a spare for the future. Six patients with malignant tumors encroaching on the globe have had definitive surgical extirpation with preservation of the eye. Three patients have had the globe uncovered successfully. Five of six patients remain disease-free, with followup from 6 months to 6 years. No globes have been removed. These techniques appear to be therapeutically sound, preserve function and appearance, and improve patient morale. The indications and limitations of this approach to certain cases of periorbital cancer are discussed.
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OBJECTIVE: To evaluate the current status of eye bank construction in Western China. METHODS: The numbers of eye banks, equipments of eye banks, methods of donor cornea preservation, fund for managing eye banks, technicians of eye banks, and difficulties in the construction of eye bank were surveyed by questionnaires from ophthalmology associations and eye banks in the following provinces and city: Sichuan province, Yunnan province, Guizhou province, Guangxi Zhuang autonomous region, Tibet autonomous region, Shanxi province, Gansu province, Ningxia Hui autonomous region, Qinghai province, Xinjiang Weiwuer autonomous region, Neimonggu autonomous region, and city of Chongqing before March 2003, and the numbers of eye banks and donor corneas obtained from January 1999 to March 2003 were also included in the study. RESULTS: The current situation of eye bank construction in Western China showed: (1) There were total 8 eye banks in 6 provinces among the 12 provinces and city of Western China. The mean coverage rate of eye bank in Western China was 50%. There were two eye banks in Chongqing and Shanxi separately, one eye bank in Sichuan, Yunnan, Gansu and Xinjiang respectively. (2) The fundamental equipment of each eye bank included super-clean worktable, slit-lamp microscope, refrigerator, and liquid nitrogen jar. There were 5 specular microscopes and 6 computers in the 8 eye banks of Western China. The moist chamber and medium-term corneal preserving medium were used as short term and medium-term storage methods to keep the endothelial cell survival of donor cornea. As a long term preservation of corneal donor, glycerine dehydration and deep low temperature were still used regularly. (3) financial support of eye bank was from hospital, government assigned fund, international Orbis organization and etc. (4) There were only one or two technicians in majority of the eye banks investigated in the study. (5) From January 1999 to March 2003, community education regarding to donation of eye was carried out forty-two times. During the same period, the donated cornea was added up to 156, and 126 of them were used in clinical transplantation. The difficulties in the construction of eye banks in Western China included: the amount of donated cornea was not enough; the technical exchange and cooperation between the eye banks were little; the patients could not afford the cost of transplantation surgery. CONCLUSIONS: The current situation of eye bank construction in Western China was behind that of rest areas in China, and the development of eye banks in Western China was not equal.
PURPOSE: This review of milestones and challenges in eye banking describes efforts made by dedicated eye bankers to ensure the quality and quantity of corneal tissue for corneal blind patients over the last 25 years. METHODS: This account is the result of the recollection of the author, discussions with eye bankers, and a review of the literature, public documents, and Eye Bank Association of America (EBAA) records. RESULTS: A measure of the success of eye banking is the fact that corneal transplant surgery is now scheduled as an elective procedure. Corneal tissue has also enjoyed a stellar safety record. This is due in part to the establishment of comprehensive medical standards by the EBAA, the accreditation of eye banks, and the training and certification of eye bank technicians. CONCLUSION: Advancements in eye banking over the last 25 years have improved the quality of life of several hundred thousand corneal blind persons in this country. More efforts must be made in the future to eliminate corneal blindness internationally.