New eye bank sheds ray of light for blind Published on November 14, 2007, 12:00 am
By James Ratemo
Source: The Standard online

NAIROBI - Millions of Kenyans with reversible blindness can now stare at the future with hope. The much-awaited eye bank is here.

Former Lions International president, Dr Ashok Mehta, and Mombasa businessman, Mr Kanubhai Babla, with Ms Monica Wangeci at Lions SightFirst Hospital in Loresho, Nairobi, last week.
Patients have the opportunity to undergo corneal transplants to correct sight impairment at an affordable cost, or even for free.
The eye bank — first of its kind in East and Central Africa — opened at the Lions SightFirst Eye Hospital in Loresho, Nairobi.
The facility is expected to meet the rising demand of corneas.

For years, eye transplant has remained a dream to many blind people in the region. Few patients of reversible blindness could afford the procedure abroad.

Cornea is the crystal clear portion of the surface of the eye that lets light enter. It is used for focusing. Its damage, therefore, reduces vision drastically.

During transplant, the disc-shaped segment of an impaired cornea is replaced. It is one of the most frequently performed human transplants throughout the world. Yet many Kenyans have had to live with reversible blindness for lack of replacement parts. But now, the patients will no longer be hopelessly groping in the dark.

Witnessing the inauguration of the Sh40 million project last month, former Lions International president, Dr Ashok Mehta, and former Director, Mr Manoj Shah, said the ultimate vision of the initiative is to offer free eye care to the poor.

"The maiden eye bank will facilitate corneal grafting at minimal cost to those able to pay, but would be free for the completely deserving patients. The facility will also be available to hospitals in Kenya," Shah said.

Since the demand for corneas is high and supply minimal, single transplant costs between Sh134,000 and Sh167,500, a price many Kenyans cannot afford. The first multipurpose medical centre
Mr Kanubhai Babla of Mombasa initially funded the bank to the tune of Sh22 million.
In fact, it has been named after Babla, who is an active member of the International Association of Lions Clubs and a philanthropist.
Though there is no specific national data on patients in need of corneal transplants, the number is estimated at thousands.
With national blindness prevalence of 0.7 per cent (250,000) and with corneal opacity contributing to 19 per cent of blind cases, about 50,000 people could be suffering from reversible blindness.
Lions Eye Hospital chairman, Dr S P Amina, said the Loresho Hospital carries out more than 6,000 cataract surgeries per year.
Currently, corneas from overseas donors are used in the transplants.
The culture of donating body organs is yet to gain popularity locally, but things are changing.

According to Dr Fayaz Khan, SightFirst chief optamologist, people wishing to donate cornea upon death should indicate their intention on donor cards and inform their families.
Once completed, the complex would also house a research and training centre, and a medical library, making it the first multipurpose medical centre in Africa.

Khan said the hospital is training officers in major hospitals on donations. The officers would be informing the eye bank of deaths, and immediate relatives of the deceased counselled.

"The process is called ‘grief counselling’. It is aimed at enlightening those involved on the need to donate their relatives’ eyes to help someone see … But voluntary donation would be encouraged," he said.
Khan said about 200 patients, from Nairobi alone, are on the transplant waiting list.

"This is a small percentage of the actual number of patients who would require the service particularly if donor material were to be made available," he added. One can donate only the cornea or the whole eye. The bank accepts donations for multiple uses. However, only the cornea and the sclera (white outer layer of the eye) can be transplanted — other parts could be used for research and education on causes and cures for other eye disorders.
Amina said persons with cataracts and poor eyesight could donate their healthy corneas. To ensure only right corneas are used, he said, extensive review of donor’s medical, family and social history is done, and the eyes and corneas thoroughly examined.
"Great care is taken to preserve the donor’s appearance through the delicate surgical removal of eyes. Funeral directors are usually able to completely restore the appearance to enable a funeral viewing if desired," he added.
"Enucleation (extraction) of the eye usually takes place within six hours of death and transplant performed within two to six days."

Laws to protect a potential donor and ensure that the quality of medical treatment is not affected are in place.

According to Amina, legal guidelines must be followed before death can be certified. A physician certifying death is not involved with the eye procurement or transplant.

At the same time, donation is made anonymous. However corneal recipients are encouraged to acknowledge donor families. Lions Eye Bank would forward letters or notes of appreciation.

"Information on both the donor and recipient is held in confidence by the Eye Bank. However, communication between recipients and donor families can often be beneficial. Questions regarding correspondence should be addressed to the Lions Eye Bank," said Amina. The eye bank also foots all bills incurred in procuring corneas.

Since 1961, more than 700,000 corneal transplants have been performed, restoring sight to men, women and children of between nine days and 103 years old.

Amina said there are competent surgeons and facilities for such operations have been available. But it is the donations that have been the missing, hence the eye bank.
He notes that the facility would restore hope for many productive young people are blighted by blindness.

To ensure that the bank was effectively and professionally run, Amina noted, the hospital has sent staff for training at Prasad Eye Hospital in Hyderabad India Eye Bank.