Cornea Donation
The clear layer in front of the coloured part of the eye is called the cornea. A corneal transplant is the replacement of a diseased cornea with clear corneal tissue taken from a deceased…
The clear layer in front of the coloured part of the eye is called the cornea. A corneal transplant is the replacement of a diseased cornea with clear corneal tissue taken from a deceased person.
In Türkiye the most common reasons for corneal transplantation are keratoconus (a change in shape in which the cornea becomes cone-shaped and bulges forward), pseudophakic bullous keratopathy (permanent corneal swelling after cataract surgery) and corneal injuries. Inherited diseases called dystrophies, in which the cornea loses its transparency, are also treated with a corneal transplant. Herpetic keratitis, the eye form of the cold sore virus, may also require a transplant in advanced cases.
Eye Banking
An eye bank is the organisation responsible for retrieving corneas, assessing their suitability for transplantation and distributing them. In Türkiye, only eye bank staff are authorised to retrieve corneas from the mortuary, and eye banks can only be set up within public institutions and universities.
The Legal Situation Regarding Corneal Transplantation in Türkiye
In Türkiye, corneal transplantation is carried out in accordance with the Directive on Eye Banks and Corneal Transplantation Centres, which came into force with approval no. 5376.203 dated 28.01.2015. Article 14 of the law on the retrieval, storage and transplantation of organs and tissues states: “Unless there is a will or declaration to the contrary, tissues such as the cornea that do not alter the body may be retrieved.”
In Türkiye, not enough corneal tissue can be obtained for transplantation. Even people who donate all their organs often do not agree to cornea donation. The reason is the mistaken belief that the whole eyeball is removed, which gives rise to the saying “I won’t have my relative’s eye gouged out”. In fact, only the clear layer of the eye is removed, and this does not affect the integrity of the body.
The Legal Situation Regarding Importing Corneas into Türkiye
Under the Directive on Eye Banks and Corneal Transplantation Centres, corneas can be imported from a bank abroad for foreign patients. This is making Türkiye a country that foreign patients choose for corneal transplantation.
No Tissue Matching Is Needed for a Corneal Transplant
The cornea is a tissue, not an organ. Under normal conditions it has no blood vessels, which means immune cells cannot reach the transplant site. This makes the cornea different from organ transplants such as the liver or heart. There is no such thing as tissue matching for the cornea.
Donor corneas undergo various tests in eye banks: a cell count (specular microscopy) and biomicroscopy to determine whether the cornea will stay clear in the long term. Blood tests are also done to check for infectious diseases in the donor, and the cause of death is investigated. If these tests show no obstacle to transplantation, the cornea can be used. Care is also taken that the age difference between donor and recipient is not too great.
How Do I Get an Organ Donor Card?
Organ donor cards prepared by the Ministry of Health can be obtained from the following institutions:
Provincial Health Directorate Organ Donation Unit
Public Health Group Directorates
State hospitals and local outpatient clinics
University hospitals
Private hospitals (some of them)
When you apply to these institutions, an organ and tissue donation form is first completed in the presence of two witnesses. You are then given a tissue and organ donor card.
Tell your family and loved ones that you wish to donate your organs after your death. That way, even if you do not have a donor card, your family can donate your organs — and because the decision was yours rather than theirs, they will feel more at peace in those painful moments.
2015 (as of November) / Corneal Transplant Figures
Number of corneal transplants performed: 2,489
Number of patients waiting: 2,938
Source: official website of the Department of Organ, Tissue Transplantation and Dialysis Services, Ministry of Health of the Republic of Türkiye (www.organ.saglik.gov.tr/web/)
Why Are Corneas Not Taken from Every Potential Donor? Why Are Some Retrieved Corneas Not Used?
Donor too old (over 70): 36.7%
Corneas dried out because the eyes of the deceased were not closed: 25.7%
Cause of death unknown: 13.9%
Relatives not giving permission: 9.9%
Corneal oedema/injury: 4.3%
Too much time since death (>15–18 hours): 3.0%
Arcus senilis (age-related lipid deposits in the cornea): 2.0%
Infectious disease in the donor: 1.7%
Pterygium (popularly known as “flesh growing over the eye”): 1.3%
Eye infections: 1.1%
Previous cataract surgery: 0.4%
Total: 100%
Source: Coşar CB, et al. “Epidemiological characteristics of donors and corneal tissue”, T Oftalmol Gaz, 36, 203–207 (2006).
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This article is for general information only and does not replace a medical examination or personalised medical advice.