Q&A responses written by Kevin Corcoran, as told to Zoe Engels, Contributing Writer and Editor
Did you know that in the United States alone, more than 6 million people have vision loss and one million have blindness, according to the Center for Disease Control and Prevention? The Eye Bank Association of America (EBAA) states that an estimated 12 million people worldwide have cornea-blindness, meaning the transparency of the cornea, the clear outer layer at the front of the eye, is impacted. EBBA is on a mission to restore sight worldwide through corneal transplants. Deceased donors’ corneas are used in these transplants to help restore sight in those suffering from corneal blindness. Approximately 95 to 98 percent of cornea transplants are successful! Since 1961, EBAA member eye banks have performed over two million sight-restoring corneal transplants.
SODA had the chance to learn more about EBAA and corneal transplants through an email Q&A with EBAA’s President and CEO, Kevin Corcoran. Keep reading to see what Kevin had to say and learn more about this type of transplant.
The Q&A
SODA: Why is it important for eyes to be donated, and how can a corneal transplant help these individuals?
Kevin Corcoran: There are no substitutes for human corneas for transplant procedures; only the donated gift of a human cornea can restore sight to those in need. Corneas were the first tissues to be transplanted—the first successful transplant was performed in 1905. The recipient, who would otherwise face a life of blindness or severe vision impairment, can return to work or school, drive cars, see their children, and participate in life as they did before losing their vision. I’ve spoken to many cornea recipients and they always say that their transplant gave them back the lives they had before.
While cornea transplants obviously benefit the recipient, they also give comfort to the donor’s family. The family members have just suffered a terrible loss but can find consolation in the fact that a piece of their loved one lives on in the recipient.
SODA: What parts of the eye are donated?
KC: Only the cornea, the outside part of the eye that would be covered by a contact lens, is used for transplant procedures. But eye banks may also recover many other parts of the eye for research or educational purposes.
Fun fact: though they are often referred to as ‘eye donors,’ typically only their corneas are provided for the transplant itself.
SODA: For those unfamiliar with the process, can you explain how eye donation works?
KC: Corneas are recovered within 24 hours of the donor’s death, and the tissue can be stored for up to 14 days before transplant. The recovery process takes 30 to 45 minutes, and our recovery technicians take great care to ensure that there is no change to the donor’s appearance so that their families can proceed with whatever funeral plans they wish, including open casket viewings.
After the corneas are evaluated at the eye bank to ensure that they’re suitable for transplant, they are sent to surgeons who have patients in need of a transplant. Because the cornea is avascular, we do not need to match blood types, and there is minimal risk of rejection, as might be the case with organ transplants.
The surgeon may replace the entire cornea, or more commonly, only the inner layer of the cornea, which has specialized cells to maintain its shape and the appropriate internal pressure. The transplant procedure takes about an hour, and recovery time can vary from a few days if only transplanting the inner layer to several weeks if transplanting the entire cornea. Most recipients’ vision will approach, if not match, their vision before their illness. Cornea transplant surgeries have 95 to 98 percent success rate, and any complications can often be addressed post-operatively or with a second transplant.
Donated corneal tissue being prepared for processing
(Photo courtesy of the Eye Bank Association of America)
SODA: How common is corneal transplantation?
KC: There are over 50,000 cornea transplants per year in the United States. [At EBAA,] we are fortunate to have a surplus of corneas for transplant, so we also send over 20,000 corneas to surgeons around the world. Many countries have shortages, particularly in the developing countries of Asia, Africa, and South America. The U.S. is by far the world’s largest source of corneas, but there are thriving eye banking communities in Europe, Australia, and parts of Asia (i.e., Japan, Korea, Singapore, and the major cities of India). Corneas that are determined to be unsuitable for transplant after evaluation are used for educational and research purposes.
SODA: Who is eligible to be a donor?
KC: Anyone can be a donor; there are no restrictions on age, gender, race, etc. As noted above, corneas are avascular, so we can transplant to and from anyone. We typically try to match donor/recipient ages within a few years because, once you get a new cornea, it’ll probably be yours for life. Also, since all human tissue deteriorates as we age, most eye banks won’t recover from donors over age 75, although we have had successful transplants using corneas from donors in their 80s.
We do have to rule out donors with certain health issues, generally blood-borne illnesses (e.g., Syphilis, Hepatitis, and HIV) because the FDA regulates corneas like other bodily tissues, where transmission through blood is a concern. We have been challenging the FDA on this, particularly the HIV restriction, because this needlessly prevents thousands of individuals from donating each year.
SODA: What are some common misconceptions about eye donation?
KC: The greatest barrier to donation is individuals’ understandable emotional response to eyes: They’re how we see the world and how we picture our loved ones, so they hold a special place in our hearts. Some communities are reluctant to donate for religious reasons, even though all major religions support donation as an altruistic gift. Some resist cornea donation for fear that their loved one will look different after the cornea recovery, but we train our technicians to take the utmost care to preserve the donor’s appearance.
SODA: Why is it important for students to learn about eye donation?
KC: High school and college students are at a life stage in which they are taking autonomy of their bodies and making important decisions about who they are and what they believe. Understanding one’s options regarding organ, eye and tissue donation is critical to making informed decisions that reflect those beliefs. Since most donor registration happens when one earns or renews their driver’s license, you have an opportunity to choose to save and restore lives, even if that won’t happen until many years in the future.
Cornea transplants help people like Alexis, who received a transplant after contracting an infection while on vacation, and Zoe, who received her transplant from 9-year-old Aolani and is pictured with Aolani's family
(Photos courtesy of the Eye Bank Association of America)
SODA: How can students help support EBAA’s mission to restore sight worldwide?
KC: Register as an organ, eye, and tissue donor at RegisterMe.org and encourage your friends and family to do the same. Participate in SODA to educate your peers and to correct misconceptions in your communities. And be sure to inform your family of your intention to donate. For more information on eye donation and corneal transplantation, visit our website: RestoreSight.org.
Did Kevin’s words resonate with you? Become an advocate for organ, eye, and tissue donation in your community. Visit sodanational.org/students to see if there is already a chapter on your campus or to host an event or start a new chapter.
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