Someone has

given me the best present in the whole world, but I don't even know who

the giver was. What I do know is that he or she was a very thoughtful,

generous and compassionate human being because I received the gift of

sight through cornea donation.

This is a good

time to have a corneal transplant. Twenty-five years ago, corneal transplants

were largely unsuccessful and 25 years from now, there may be a shortage

of corneas for transplant, due to the tremendous popularity of LASIK eye

surgery. More than 1.25 million people in the United States had LASIK

surgery in 2001 and estimates are even higher for the future. That could

result in millions of corneas being lost for transplantation, though they

could still be used for research and teaching.

"We won't

know the impact of LASIK surgery on cornea transplants for 15 to 20 years,"

according to Dr. Edward Holland, director of Cornea Services at the Cincinnati

Eye Institute and medical director at the Northern Kentucky Eye Laser

Center.

The Eye Bank

Association of America in Washington, D.C. (EBAA), a nonprofit organization

with 108 member eye banks, ensures tissue safety by means of strict requirements

for its members. Currently, LASIK surgery is in the EBAA medical standards

as a contraindication (a condition that makes a particular procedure inadvisable)

for corneal transplants. What can be done about this possible crisis?

First and foremost,

we all need to consider being organ and tissue donors right now. Note

your wish on your driver's license, fill out donor cards at your local

eye bank, put it in your will, but most importantly, tell your next of

kin.

"It is

extremely important that the family knows about the donor's wishes,"

says Rusty Kelly, EBAA chief operating officer and managing director.

When the family clearly understands the donor's consent to tissue and

organ donation, they can help ensure those wishes are carried out.

Dr. Holland

says there is a major cornea shortage internationally today, excluding

the United States and Western Europe. Unfortunately there are countries

where no cornea transplants are performed at all and others where only

the wealthiest of patients receive them.

"Cornea

disease is the leading cause of blindness in one of eight people throughout

the world," adds Dr. Holland, a noted cornea expert.

The cornea

is the clear tissue in front of the pupil and the iris, acting like a

windowpane. It is the main focusing element of the eye and if it becomes

cloudy from disease (as mine did), infection or injury, vision will be

dramatically reduced.

Well over 90

percent of corneal transplant operations are successful today, but it

hasn't always been so. The first transplant was performed in 1905 and

the operations were largely unsuccessful until the late 1970s. Advances

in modern medicine, such as improved surgical techniques, operating with

microscopes, improved sutures and advances in eye banking, have sparked

a turn around in the success rate of corneal transplants.

The first eye

bank to procure and distribute eye tissue for transplantation, education

and research was established in the 1950s in New York City and by the

1970s, a network of such banks had spread across the country. The EBAA

was established in 1961.

More than 50,000

corneas were distributed by 88 eye banks in the United States and Canada

in 2000, according to EBAA statistics. Most were used for the 45,000 corneal

transplants in this country, but some were distributed internationally.

The increased

efficiency in eye banking is especially evident in storage capabilities.

A cornea now can be stored for two weeks, although corneas are usually

distributed in far less time, according to Carol Engel, executive director

of the Minnesota Lions Eye Bank in Minneapolis.

"The practice

across the country is to distribute the tissue within three to five days

from the time of recovery," explains Kelly.

Recovery occurs

within six hours of death, after which the cornea is taken to an eye bank

within a certain time period. Criteria for potential tissue donors vary

from eye bank to eye bank after meeting EBAA standards, depending upon

the needs of the community.

EBAA 2000 figures

show that 89 percent of all donors were Caucasian, 85 percent of the donors

were 41 years or older, and men outnumbered women as donors almost two

to one. The most common causes of donor deaths were heart disease (39

percent) and cancer (17 percent).

The cornea

has no blood vessels so tissue typing is not necessary for a corneal transplant,

as with organ transplants. Gender, race and eye color do not enter into

corneal transplant criteria either. That makes me even more curious about

my new cornea and what sort of a life it had before it became my window

on the world.

Since the gift

of sight is made anonymously, recipients should express gratitude to all

tissue donors in the past. As for the future, please act now. Become a

donor, tell your family and spread the word.

(For more

information, contact Jane Boller at (952) 933-5199 or [email protected] .)

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