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Wisconsin Lions Eye Bank

  The cornea of the eye is our window to the world.  It is the thin, outermost layer across the front of the eye that controls and focuses the entry of light into the eye.  Infection, corneal disease, injury and certain age-related conditions can cause irreversible scarring and damage to the cornea, resulting in the loss of sight.

            On December 7, 1905, Dr. Edward Zirm performed the first successful and permanent corneal transplant.  The procedure was performed on Alois Glogar, a farmer who was suffering from the results of chemical lye burns.  The cornea was an 11-year-old boy named Karl Brauer.

            Since then, corneal transplants (Keratoplasty) have become the most common and successful form of tissue transplantation.  Nearly 700,00 cornea transplants have taken place throughout the United States During the last 40 years, giving the Gift of Sight to men women and children, ages nine days to 103 years old.  The success rate of the corneal transplant procedure usually exceeds 90 percent.

            The delicate and careful process of cornea recovery enables the medical community to maintain this incredibly high success rate.  It takes the courage and generosity of hundreds of individuals to make this process possible.

            The Lions Eye Bank of Wisconsin has taken on the responsibility of ensuring the success of corneal transplantation in Wisconsin.  In 1953, eye banking began at the Marquette Medical School in Milwaukee.  During the 1960s, Madison’s University Hospital and Milwaukee’s Eye Institute built their own eye banking facilities and local Lions groups became interested in volunteering at the eye banks in order to help the eye banks achieve their goals.

            In the late 1990’s eye bank employees and Lion volunteers started looking at the possibility of combining the two Wisconsin eye recovery organizations in order to create a more streamlined approach to eye banking.  Mark Larson, current Director of the Lions Eye Bank, states that, “the goal at that time was to provide more service with fewer resources and become more efficient.”

            In 1996, there was a waiting list for patients in need of a cornea transplant.  Mr. Larson acknowledges that there was a need to improve the corneal recovery system and assisted in the process that led to the elimination of the waiting list.  “We thought that by

Increasing our donor numbers through merging the organizations, we could eliminate the waiting list and move to scheduled surgery, and that’s what we’ve accomplished in the last five years.”

            In 1998, the reorganization was completed and the Lions Eye Bank was incorporated.  Currently, the Lions Eye Bank of Wisconsin functions effectively and successfully with the assistance of a 23-person board of directors.  The list of board members consists of Lions members, ophthalmologists, a coroner, a donor mother, a deputy chief medical examiner, transplant surgeons, a funeral director, ophthalmology medical researchers, an emergency room nurse and a hospital chaplain.  However, the Lions Eye Bank could not exist without its 11 full-time employees, more that 600 Lions clubs, participating hospitals and health professionals, and of course, the donors and their families. 

            It all begins with a donor and a donor family.  Death of a loved one is never easy.  The gift of eye, organ and tissue donation not only benefits the transplant recipients, but also eases the pain and grief of a donor family by offering a measure of comfort.  Cornea donation occurs at no cost to the donor family.

            Because the need for eye, organ and tissue donation is so great, hospital personnel are required to offer the option of donation to all eligible families.  This has been made possible through federal regulations which standardize the efforts of all the transplant agencies.  Permission for donation is requested from legal next of kin in the following order:

1.      Spouse

2.      Adult son or daughter

3.      Parent

4.      Adult brother of sister

5.      Legal guardian

      The safety and effectiveness of the transplant is the prime consideration in the

recovery and testing process.  Each potential donor is screened to determine suitability for organ, tissue and eye donation.  Careful attention is paid to the presence of infectious disease processes.  Medical, family and social history interviews and consultations are conducted.  Eyes and corneas are thoroughly examined in the eye bank laboratory.  Serology blood testing is performed for HIV (AIDS) Hepatitis B, Hepatitis C and Syphilis.

            When preliminary donor suitability has been determined and consent has been granted by the family, trained health professionals begin the process of eye recovery.  This surgical procedure, known as enucleation, is usually accomplished within six hours of death and preservation of the corneas generally takes place within 12 hours of death.

            Across the state of Wisconsin, professionally trained, certified eye enucleators recover the eyes and prepare them for transportation to the Lions Eye Bank.  More than 900 volunteer members of the Lions clubs come together to create a network of delivery routes and relay points throughout the state.  These dedicated volunteers provide delivery of the recovered eyes to the Lions Eye Bank in a safe and timely manner.  Last year, Lions transported 643 eyes to the Lions Eye Bank of Wisconsin.

            After the eyes have been delivered to the eye bank, they are carefully examined, and the corneas are surgically removed in a sterile environment.  The corneas are placed in protective sterile chambers containing a preservation media that enables refrigerated storage for a number of days.  Surgeons are notified of the availability of suitable corneas.  When a surgeon accepts a cornea for a recipient, the Lions transportation system is reversed and the corneas are delivered to the appropriate surgery center for transplantation.  Last year, Lions made 394 of these deliveries.  Day or night, rain or snow, these volunteers continually aid in the vigilant effort to transport the priceless donations that give the Gift of Sight.

            Today, corneal transplants are a scheduled medical procedure; however, emergency transplants are preformed, as they become necessary.  During surgery, the patient is usually awake and under local anesthesia.  The damaged cornea is removed by trephination and the donated corneal graft is then sutured into place.

            The patient typically recovers quickly, but healing and restored vision may take up to 12 to 18 months.  Cornea matching is not necessary, as a lower level of rejection occurs than is solid organ transplant probably due to the avascular nature of the corneal.  Nevertheless, rejection is always a possibility.  Signs of rejection include redness in the eye and deterioration of vision.  If dealt with quickly, rejection can be controlled with a number of medications, including steroids and immunosuppressants.  I a transplant fails, the patient can undergo another corneal transplant at a late time.

            The generosity of Wisconsin donors has enabled the supply of corneas to meet the need and to sometimes enable the eye bank to share corneas with other eye banks and programs across the nation.  The eye bank also contributes to charitable international missions that provide other countries with corneas for transplant.

            Occasionally, recovered eyes are not deemed suitable for transplant use, but may be usable is research or educational efforts.  In such instances, the eyes or ocular tissues are sent to researchers and educators at the Departments of Ophthalmology at the University of Wisconsin-Madison and the Medical College of Wisconsin-Milwaukee.  The Lions Eye Bank of Wisconsin realizes the need for research and embraces the opportunity to assist in the advancement of ocular science and discovery.

            Each donor family receives information about the general circumstances of their donation; however, patient confidentiality is observed through anonymity.  All inquiries and correspondence between the donor family and the recipient must take place through the eye bank until both parties mutually agree to correspond or meet.

            The Lions Eye Bank of Wisconsin is a member of Eye Bank Association of America (EBAA).  The EBAA mission is:

“Restoring sight through the promotion and advancement of eye banking.”

            Ninety-eight percent of all eye banks belong to the EBAA, which provides medical standards for member organizations.  The EBAA accredits and certified eye bank, trains eye bank technicians and inspects each eye bank to ensure adherence to the highest standards of quality and safety.  The Lions Eye Bank of Wisconsin is a fully accredited member of the EBAA and continues to achieve the highest accreditation status obtainable.

            Signing the donor area of your driver’s license, affixing donor sticker’s and carrying a donor card are all excellent ways to declare your intent to become a donor.  However, in the event of your death, family consent for eye, organ and tissue donation will be sought even in the presence of a signed donor card or driver’s license.  The best way to ensure your wish to become a donor is honored is to discuss donation with your family.

“Share your Life.  Share your Decision.”

            Tens of thousands of people in the United States need corneal transplants each year.  Millions of people worldwide are also in need of a sight restoring corneal transplant.  Thanks to heroic and compassionate donor families, many have received the Gift of Sight.

To learn more about the eye bank, visit www.eyebankwis.com

Rachel Primmer is a freelance writer in Wisconsin.  She can be reached at writer@turnthepage.net.