The Florida Lions Eye Bank is the bridge between a loved one departed and the beauty of sight restored.
The role of an eye bank: from donor to recipient
The first successful corneal transplant was performed in 1905, but corneal transplantation remained an uncommon procedure until the first eye bank opened forty years later. The innovation of eye banking made it possible for corneas to be preserved long enough to be shipped to surgical facilities, where patients waited for the invaluable tissue that would return their vision.
Today, eye banks around the world remain the bridge between donor and recipient. For over 50 years in South Florida, the Florida Lions Eye Bank has been the link between a loved one departed and the beauty of sight restored. But how exactly does this happen? Below is a step-by-step outline of how the Florida Lions Eye Bank transforms one person’s selfless wish to donate into another person’s ability to see.
How the process begins
The Florida Lions Eye Bank receives a call from a hospital, medical examiner’s office, or funeral home, notifying us of the death of an individual. Our trained screeners speak to the caller to ascertain whether this individual meets preliminary criteria for eye donation.
If the deceased is preliminarily suitable as an eye donor, the Florida Lions Eye Bank has a very short window of time to contact the next of kin, perform a medical and social history questionnaire, and recover eye tissue. This needs to happen within 24 hours of the time of death, but sooner is preferable. Once we determine whether an individual meets preliminary criteria for eye donation, we move very quickly to ensure the best possible outcome for the recipient.
Our first step is checking the donor registry. In Florida, anyone who wishes to be a donor of eyes, organs, and other tissues can register at donatelifeflorida.org. If the deceased is registered as an eye/ organ/tissue donor, then the Florida Lions Eye Bank is in the fortunate position of knowing his or her wishes. This makes the discussion about donation much easier for the next of kin.
Speaking to the donor's family
The Florida Lions Eye Bank contacts the potential donor’s next of kin to discuss eye donation. If the deceased is registered as an eye/ organ/ tissue donor, we notify the next of kin of this selfless decision. If not, the next of kin has the opportunity to consent on behalf of the deceased, giving the gift of sight to others in need.
In either case, the Florida Lions Eye Bank goes through a medical and social history questionnaire (MSHQ) about the donor with someone he or she knew well. This interview can be done over the phone, and it takes about 20 minutes to complete. The questions asked are similar to those asked prior to blood donation: some are personal in nature, but all are asked to ensure the safety of the recipient.
The Florida Lions Eye Bank also obtains copies of the donor’s relevant medical records to learn more about the cause and circumstances of death. The information we gather from these medical records and the MSHQ allows us to make a donor eligibility determination. Once this determination is made, the Florida Lions Eye Bank proceeds to recover tissue.
The recovery procedure
A trained recovery technician travels from the Florida Lions Eye Bank to the donor’s location, usually a hospital or medical examiner’s office. The first step in the recovery procedure is an examination of the donor’s body to screen for signs of infectious disease or indications of high-risk behavior, such as intravenous drug use. Then, the recovery technician draws a sample of the donor’s blood to be tested for viral hepatitis, syphilis, HIV, and other blood-borne diseases.
Next, the donor’s eyes and face are prepared for recovery using an antiseptic surgical solution. The technician dons a gown, mask, and gloves, and drapes the donor’s face to create a sterile field. He or she removes the donor’s cornea using very fine, specialized surgical tools which minimize folding or pulling of the tissue, and ensure that the donor’s face is unaffected by the recovery procedure. As each cornea is recovered, it is placed in storage media to keep the cells viable.
When the recovery procedure is finished, the technician places a plastic prosthesis in each eye to retain its shape, and closes the donor’s eyelids. The entire procedure takes 15-20 minutes from start to finish. Cornea donation does not delay funeral arrangements, and the donor’s family can still have a viewing if they choose.
From eye bank to operating room
The recovery technician brings the corneal tissue back to the Florida Lions Eye Bank’s laboratory, where it is evaluated microscopically to check for deformities or damage. The blood sample drawn from the donor is tested for infectious diseases that would present a danger to the recipient. Our staff reviews all the compiled information, to make absolutely certain that the tissue is both safe and of sufficient quality. If everything is OK, the tissue is deemed suitable for surgical use, and shipped to a surgeon for transplantation.
Meanwhile, the recipient is preparing for his or her corneal transplant. Most cornea recipients are patients suffering from long-term corneal disease that gradually causes blindness. For many of these patients, a transplant is the last hope of restoring sight, following months or years of other types of treatment. Fortunately, patients in the United States do not generally have to endure long waits for corneal tissue. This is due to a large number of selfless donors and the cooperation of their families, as well the meticulous work of eye banks throughout the country.
The day of the transplant, the patient arrives at the surgery center and is brought to the operating room. The transplanting surgeon removes the central portion of the donor cornea with a trephine, an instrument resembling a small round cookie cutter. The surgeon then excises the damaged cornea from the patient’s eye using the same trephine, so the shape of the excision matches that of the graft. Finally, the donor cornea is sutured into place. The entire procedure usually takes about an hour, and in most cases, the recipient goes home the same day.
The beauty of sight restored
The cornea recipient follows up with his or her surgeon as needed to ensure the transplant is healing and achieving the clarity needed to restore vision. If the recipient wishes to contact the donor’s family, she or he can ask the transplanting surgeon how to get in touch with the Florida Lions Eye Bank. While corneal transplant recipients will not be told the name of their donor, they may choose to write letters of gratitude to their donors’ families, which the Florida Lions Eye Bank helps to deliver.
Finally, the Florida Lions Eye Banks sends a letter to each donor family several months after donation to acknowledge the beauty of sight that was restored to others in need. Throughout the year, the Florida Lions Eye Bank also offers several programs to honor the sacrifice made by all of our donors. And of course, the Florida Lions Eye Bank invites all transplant recipients, donor families, or anyone with questions to contact us.