More receiving gift of sight

SINGAPORE — For years, 23-year-old Mr N Palanivelu lived with blurred, distorted vision that could not be corrected with spectacles, due to an eye disorder called keratoconus.

The progressive eye disease causes the cornea — the transparent outer layer of the eye — to take on an irregular, cone-like shape. Over time, his vision woes intensified.

That changed in January this year after Mr Palanivelu underwent a transplant. Since replacing his diseased right cornea with a new one, Mr Palanivelu said the pounding headaches due to his worsening eye condition have disappeared.

“Initially, I was fearful of going for the transplant surgery. But I don’t have any regrets as I feel energised and confident now that I can see more clearly,” he said.

An increasing number of local corneal donations and successful corneal transplant surgeries performed in Singapore mean that more patients, such as Mr Palanivelu, have had their sight restored.

Last year, local corneal donations to the Singapore Eye Bank (SEB) numbered 222, a 75 per cent jump from 127 in 2014. This contributed to the local waiting list shrinking from 38 people in 2014, to 25 as of end-2015.

A total of 432 corneal transplantations were performed in Singapore last year, a 27 per cent rise compared with 341 transplants in 2010.

Presently, only about a third of corneal transplantations performed here use local tissue, with the remainder acquired from internationally accredited eye banks from Sri Lanka, Manila in the Philippines, and the United States.

Singapore is currently among the top three Asian countries in corneal tissue procurement per capita, alongside Sri Lanka and India, according to a global survey of corneal transplantation and eye banking published in the JAMA Ophthalmology journal in February.

But an active local cornea procurement programme has boosted local donor numbers, shaving off waiting time for patients who require corneal transplants, according to Professor Donald Tan, SEB’s medical director.

The Hospital Eye Donation Programme, which started in Singapore General Hospital (SGH), now runs in three other restructured hospitals: Tan Tock Seng Hospital since 2002, Changi General Hospital since 2004 and the National University Hospital since 2013.

“Unlike other organ or tissue transplants, the average waiting time for a corneal transplant is now only 68 days,” said Prof Tan.

From 2011 to 2014, the average waiting time was about 73 days, said SEB senior eye donation counsellor Jenny Zeng. By comparison, the ­average waiting time for a deceased kidney donor is about 10 years, she added.

FAMILIES MORE ACCEPTING OF CORNEAL DONATIONS

Greater public awareness and acceptance of organ and tissue donations have helped drive numbers up.

“In the past, most of the donors’ families were reluctant to give consent because they felt that harvesting the corneas would mean a major operation for the deceased,” said Ms Zeng.

“With more public education, people are now more knowledgeable and understand that removing the corneas does not change their loved ones’ appearance, and the process is simple and fast. Moreover, one donor’s corneas can help two people restore their sight and change their lives.”

Corneas are typically harvested at the bedside in the ward or mortuary in a procedure that takes about 40 minutes to an hour, after the deceased is deemed to be suitable for donation and next-of-kin gives consent, said SEB senior manager Howard Cajucom-Uy.

A corneal transplant is required when one’s cornea is damaged or diseased, rendering it cloudy and resulting in blurred vision. The majority of transplant cases are older adults with age-related conditions.

However, about a quarter of corneal transplants performed in Singapore are on patients aged 40 and younger, said Prof Tan. In younger individuals, severe contact lens infections and keratoconus are the most common cause for corneal transplantation.