The non-acceptance of corneal transplantation in the third world continues to be a problem. It is encouraging to see that efforts to increase acceptance are being made in Syria. I should also acknowledge that Dr. David Paton, who started Orbis' Flying Eye Hospital, also started the first eye bank in the Middle East. (The article also quotes my friend, Dr. Hunter Cherwek, the current medical director of Orbis).
Orbis continues to promote corneal transplantation in every country it goes to. In fact, the article reminds me of an interview I and an Orbis colleague of mine, Dr. Ahmed Gomaa, did in conjunction with a local ophthalmologist in Enugu, Nigeria last summer. The interview was nationally televised and accepted calls from listeners. One caller asked, with great concern evident in his voice, whether or not a corneal donor would still be able to see in the after-life. The local ophthalmologist gave a colorful answer replete with Biblical references that convinced the caller that he would have vision in Heaven even if he donated his corneas. The entire exchange was quite charming, yet not one that would typically occur in most nationally televised debates in America.
Eye donation recently got a new public face in Syria, where the Grand Mufti, the highest official of religious law, pledged to donate his corneas upon death to help one of the thousands of people waiting for transplants there. In India, it is Bollywood film stars like Aishwarya Rai Bachchan, the former Miss World, who have pledged their eye tissue for transplant.
Doctors in Syria perform hundreds of transplants a year, said Dr. Said, director of the National Program for Blindness Control. But the supply of tissue from the United States has been dropping, and the corneas the country does get go only to wealthy people who will pay $1,000 or more per eye. A new eye bank in Syria is part of a regional effort to drum up corneal tissue in the Middle East and parts of northern Africa.
“As corneal transplants become more and more successful, there are more and more candidates for the procedure,” said Dr. Hunter Cherwek, medical director of the Flying Eye Hospital, a DC-10 airplane run by the nonprofit group Orbis that flies to various countries to train eye surgeons. “It truly becomes a supply and demand issue, where the techniques are expanding the demand.”
Orbis is working with a government agency to increase eye donations in Vietnam, where Dr. Cherwek estimates that “thousands, likely tens of thousands could benefit from corneal transplantation.”
The shortage of eye tissue in many places means that transplants are available only to the wealthy. Building domestic eye banks, experts say, could reduce the price of corneas and allow more people to get transplants. But the experts also say that such growth, however beneficial, is unlikely to improve a more basic problem: lack of access to eye care for the poor.