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Hitherto, In Sri Lanka removal of eyes was confined only from criminals sentenced to death. As a young medical officer, late Dr. Hudson Silva was interested in helping the blind and in 1958 published an article in the newspapers requesting eyes from donors and the response was beyond expectations He is the pioneer in introducing eye donation as a national habit in Sri Lanka and in 1961 he founded Sri Lanka Eye Donation Society.

In 1964 we started our international service, the first shipment of 06 eyes was sent to Singapore. The noble concept of “Eye Donation” spread not only in Sri Lanka but also internationally. Up to now over 55,000 corneas were donated in Sri Lanka whilst 81,614 blind patients in 57 countries including Japan, Korea, Thailand, India, Pakistan, China, Taiwan, Saudi Arabia, Greece, New Zealand and South Africa received our eyes. In addition, our eye bank has donated over 43,000 corneas for research & development work.

Sri Lanka International Eye Bank is in a unique position of having supplied 81,614 donor corneas to 114 cities in 57 countries by 27th June 2021. The eye bank’s experiences span a period of 60 years as an international donor. This is because we were not content merely to supply our own requirement. When we knew that there was a world-wide shortage of donor eyes and Sri Lanka had the potential to help so many countries, we did not relax. Even when we were receiving hundred percent extra eyes than needed in Sri Lanka way back in 1966, we kept on trying to get more and more eyes until today the supply is ten times the need of the country

Today we have a dedicated staff of 47 consisting of highly competent medical director, managers, technologist and others. We have decentralized our operations with the establishment of 06 centers in the outstation with a technician for each center. In addition we have 450 branches spread throughout this country. Nearly 2,000,000 persons all over the country have officially consented to donate their eyes after death by singing consent forms. These facts by itself speak for the enormous charitable service rendered by this eye bank not only in Sri Lanka but also internationally.

Click here to make a cornea request online. Cornea Request Form

For the requirements in a small hospital, equipment and man power needed are minimal. It is not necessary to match the equipment and systems in an advanced Eye Bank which has vast resources and serves a larger population. A refrigerator, enucleating instruments, a telephone, transport, and access to laboratory for some tests are the basic requirements; the most important factor needed is a highly motivated doctor or/and technician who are prepared to work long and irregular hours.

Storage in a refrigerator at this temperature may be the only method of preservation needed in a small hospital where the keratoplasty operation is likely to be done on the same day or the next. Moist Chamber method of preservation of the complete globe after antibiotic treatment seems adequate.

Over 45 years ago fresh globes were kept immersed in liquid paraffin until used. Washing off liquid paraffin was a real hazard taking much of a surgeon’s time and the uncertainty at the end whether all the oily substance has been removed. Moist Chamber method gets rid of this very real problem.

If the cornea have to be kept for more than a day or two, either because patients are not immediately available or the cornea have to be transported to another part of the country, one of the preservative fluids has to be used.

 

McCAREY – KAUFMAN (MK)

  • This fluid is ideally suited to preserve a corneal button up to 03 or 04 day. This fluid can be prepared in any clean lab.

 

OPTISOL GS

  • Fluid gives a longer life span (up to 14 days) and is a commercial product costing US $ 100 – 150 for single vial.

 

EUSOL-C

  • Fluid gives a longer life span (up to 14 days) and is a commercial product costing US $ 100 – 150 for single vial.

 

MINIMUM ESSENTIAL MEDIUM

  • Which is a culture medium is ideally suited for long term (up to 03 weeks) preservation. Another advantage is that THERE IS NO REFREGIRATION NEEDED once the cornea has been immersed in this fluid. Cornea may be transported very long distance over a number of days because refrigeration on the way is not needed.
  • All corneas are examined by slit lamp Biomicroscopy. Endothelial counts and Pachymetry are done using the endothelial microscope.
  • The longest time interval we have experienced between the death of donor in Sri Lanka, and the utilization of the cornea in Kitwe (Zambia) has been 11 days good result for penetrating keratoplasty.

The Quality policy of the Sri Lanka International Eye Bank, is to guarantee ethical, Legal, safe and efficient supply of sterile corneas by using modern techniques.

To this end all staff is trained in the task they are expected to perform in process of procument, preparation and distribution, and all materials are traceable to the source. Proper documentation is done to enable traceability.

General

  • SLIEB ensure that purchasing materials meet specified requirement by use of reliable suppliers and inspection techniques according to documented procedure. (W.H.O.)
  • Donated corneas are procured under strictly controlled procedure to ensure Health and safety of personal and the recipient of the donated eyes.

 

Assessment of supplier

  • Supplier of purchased materials is selected from approved sources.

 

Purchasing data

  • Purchasing documents specify the identification, grade, relevant specification, Quantity and packing arrangements of all products or services.

 

Verification of Purchased Products

  • The lab manager (LM) is responsible for ensuring that system exists for product identification and traceability.
  • Positive material identification is practiced at all stages from donor sources to recipients of sterile tissue materials.
  • Management and staff are responsible for initiating and for maintaining such identification and traceability of the activities under their control.
  • Identification and traceability is applied to non-sterile tissue, part-processed Materials and finished products and staff responsible for product manufacture and inspection.
  • Inspection and process records bear the specific identification of batches to which they relate. They are done according to W.H.O. requirements.

 

Inspection and Testing

  • LM is responsible for establishing and maintenance of testing equipment.
  • Obsolete and unsuitable equipment is removed from services and are either disposed of or identified to prevent inadvertent use.

 

Inspection and Test Status

  • Responsibility for identifying the inspection and test status of material intermediates and finished product lies with LM.
  • Procured tissue awaiting result of blood tests is identified during refrigerated storage to prevent inadvertent commencement of processing.

Handling

  • Safe handling methods are maintained and employed during all activities to prevent damage and deterioration of materials and finished products and to maintain health and safety requirement.
  • Sealed containers are used at all times for the handling of materials and finished products.

 

Storage

  • Processed tissues are stored in conditions according to the type of preservation Media.
  • MK -> +40C
  • Optisol GS -> +40C
  • Eusol-C -> +40C
  • MEM -> Room Temperature

 

Packaging

Procured tissues are contained in glass containers with media. These are sealed to prevent contamination of contents. Sterile tissue package are labeled with graft/batch numbers description of content and information necessary to trace source of tissue.

Sterile tissues are accompanied by users’ forms to enable tractability to recipients and review of post-operative performance. Samples of media and tissues are checked for evidence of infection.

 

Delivery

Is done by the SLIEB or the relevant Hospital/Doctor which the operation is to carry out. Delivery box can maintain the cornea +40C upto 2-3 days. Each delivery is accompanied by identifiable and traceable documentation.

 

Quality Record. (Maintained by the LM)

  • LM is responsible for identification of quality record requirements and assessing the contribution of the quality records to the overall effectiveness.
  • In addition he is responsible for ensuring the collection and filling of quality records.
  • Quality records are reviewed on a regular basis by the LM and trends are investigated prior to presentation for review.

 

Training

  • Medical Director (MD) is respo4sible for identification of training and for ensuring that the staff is trained according to such needs.
  • Training records and training needs are maintained for all personnel on-an individual basis according to approved procedures and relevance to their Job activity
  • LM monitors and ensures that documented procedures are followed and all the necessary process and inspection records are prepared.
  • Tissue grafts are limited to use by physician only
  • This tissue is intend for use in one patient, on a single occasion only
  • No known possible significant adverse reaction
  • Tissue was prepared from a donor who was negative when tested of HIV 1/2, Hepatitis B, Hepatitis c, VDRL
  • Tissue is sterile under recommended procedures
  • Once opened cannot be sterilize or re-sterilize
  • It is the sole responsibility of the clinician to store and transplant the tissue under the guidelines and maintain records to trace them post-transplant.,
  • No known Sensitizing agents.
  • Recommended Storage conditions: +40C or room temperature.
  • Time: MK (5days), Optisol GS (14days), Eusol-C (14days), MEM (21days)