Restart cornea imports to ease patients' suffering, say doctors

Specialists want cornea imports resumed to ease a shortage in donations so more patients with debilitating eye problems can be helped

PUBLISHED : Wednesday, 26 June, 2013, 12:00am
UPDATED : Wednesday, 26 June, 2013, 2:33pm

Eye doctors want Hong Kong to resume importing corneas to ease a shortage that is depriving some patients of vision-restoring transplants.

Despite new technology that enables one cornea to be divided for use in up to six patients, there are still not enough, said Dr Alvin Young, chairman of the Hospital Authority's co-ordinating committee in ophthalmology.

"Since we don't have enough corneas, we have to play God [in deciding who gets a transplant]," said Young, who is also chief of ophthalmology at Prince of Wales Hospital.

"Don't be mistaken that being able to divide a cornea into layers means that we have enough. Not all cases are suitable for division and transplants have their life span."

Last year, 259 corneas were donated - the most in a decade - but 500 people remained on the waiting list for transplants at the end of the year.

Hong Kong once imported corneas from Sri Lanka, but stopped in the 1990s as local donations increased.

Young said that from a doctor's point of view, it would make sense to resume imports to help more people, but it was up to the authorities to decide whether it should be done.

Some patients who have already had several transplants or who suffer from blurred vision in only one eye but no pain may not make it onto the transplant list. But in countries where supplies of corneas are adequate, such patients would receive transplants.

Young said quality control over the supply of imported corneas had been a problem in the past, but using internationally accredited quality-control eye banks in exporter countries such as the United States would address the quality issue.

He also said more local donations should be encouraged.

Most patients requiring a transplant in Hong Kong suffer from corneal scarring, degeneration or deformation, usually as the result of injury or infection.

Unlike other organ transplants, corneal replacements do not require tissue typing or blood matching, meaning that any cornea can be implanted in any recipient.

In the deceased, the eye deteriorates more slowly than other organs, and even cancer patients can be donors.

Corneas can be preserved for two weeks after being removed from a corpse, meaning they can be exported relatively easily.

"We won't let any usable parts go to waste," Young said, explaining that the number of beneficiaries from each donated cornea depended on its quality.

Sri Lanka exports about 3,000 corneas a year, and has provided tissue to 57 countries over nearly half a century, with Pakistan receiving the biggest share, according to the non-profit Sri Lanka Eye Donation Society.

A new, state-of-the-art government eye bank opened in the country in 2011, funded by Singaporean donors.