ENUCLEATION AND PRESERVATION OF EYE BALLS

In our country, the removal of eye balls from a dead body is done either by an ophthalmologist or trained registered medical practitioner. Before removal, the eyes are made aseptic by putting a few drops of antibiotics in the eyes. It is essential to prevent contamination of the cornea not only during its removal but also while storing and preserving it.

The usual precautions such as sterilizing the instruments, wearing of the gloves, etc., are also taken. It takes about 15 to 20 minutes to remove the eyes. After the eyes have been removed, a ball of cotton wool is tightly packed in the empty eye socket. The eye lids are stitched with a black thread. It gives an appearance as if the donor is asleep. Sometimes, artificial eyes are inserted in the gap formed so as to give it a natural appearance. The belief that the donor’s face is mutilated due to removal of cornea is erroneous.

Quality of Donor Corneas

Age: Although the age need not be the sole criterion, the death of an otherwise healthy young/middle aged person (age 10 to 50 years) provides better donor corneas.With advancing age, especially for age group in +80 it is less than 5 percent and are seldom useful to give sight to blind.

Time Interval: The earlier the cornea is removed after the occurrence of death of the donor, the better will be its quality. Unless preserved at a temperature of 4deg C, the corneal tissue degenerates completely after 6 hours of death. In the cold climate, the rate of deterioration is slower.

Other Factors: It is wrongly believed that the corneas of people wearing spectacles for improving short or long distance vision or of patients operated for cataract cannot be used. In fact, the corneas of such donors are as useful as in the case of the other donors. However, corneas of patients suffering from leukemia (blood cancer), AIDS, rabies (hydrophobia), snake bite, tetanus, syphilis, viral hepatitis and brain tumor cannot be used for corneal transplant.

As per the provisions of the “Transplantation of Human Organs Act, 1994,” applicable to the States of Maharashtra, Goa and Himachal Pradesh and all Union Terrtories, in the first instance, and the Corneal Grafting Act in force in other states, only a registered medical practitioner is permitted to “enucleate” the eyes from a dead body. In the U.S.A. and several other countries, any individual after undergoing proper training from an Ophthalmic Surgeon is permitted to remove the eyes for the purpose of transplant.

This helps in saving the precious time of medical practitioners including eye surgeon. Such trained technicians with their exposure and experience employed full-time by an eye bank can also provide valuable assistance in organizing several other activities including motivation for eye donation.

The eye balls after enucleation are put in sterile bottles called moist chambers which contain metal clamps/stands to hold the eyeball. They are then rushed to the eyebank in a vacuum flask containing ice as soon as possible.