PESHAWAR: Granting registration for cornea transplantation by Medical Transplant Regulatory Authority (MTRA) to four hospitals, both public and private, will benefit the patients, say ophthalmologists.

“Scores of people have been waiting for cornea transplantation. As the MTRA has granted registration, we have started restoring eyesight of the poor people free of cost,” Dr Zaman Shah, ophthalmologist at medical teaching institution (MTI) Khyber Teaching Hospital, told Dawn.

The KTH along with Lady Reading Hospital, Pakistan Institute of Community Ophthalmology, Hayatabad Medical Complex and privately-run Rehman Medical Institute were authorised for corneal transplant for one year. A notification in this regard was issued by MTRA on Monday.

The health department formed MTRA in line with Medical Transplantation Regulatory Authority Act, 2014, to do away with illegal transplantation of organs and promote the legitimate procedures to save lives. The Institute of Kidney Diseases was accorded recognition for renal transplant in February where the first case was conducted last month successfully.

However, ophthalmologists at the city’s hospitals requested MTRA to soften the rules for cornea transplant because it didn’t need involvement of so many specialists and intensive care unit like the renal transplants. They said that they should be authorised to restore the eyesight of people.

Four health facilities registered for one year to conduct cornea transplant

“As there is no concept of donation of organs in the country, corneas are sent from abroad, mostly by Association of Physicians of Pakistani of North America (Appna) to be transplanted to the needy people back home,” said Dr Zaman. He said that Al-Rahim Trust was facilitating the shipment of cornea from Sri Lanka that provided 50 corneas in collaboration with Sri Lanka-Pakistan Friendship Association in addition to 45 corneas received from Appna.

The procedure costs Rs150, 000 in private sector but the latest design to authorise the public sector hospital would benefit the poor people blinded by diseases or trauma.

Dr Zaman said that people visiting the hospital with symptoms of Keratoconus -- a disease which caused progressive thinning of cornea -- were selected for transplantation. “Now we are going to select five more patients prior to sending requests for more corneas. Patients would get the same regardless of their financial status,” he added.

Dr Fazl Majeed, the deputy administrator of MTRA, said that the hospitals recognised for cornea transplant must have services of surgeons,evaluation committees, coordinator and eye bank for storage of corneas with national and international linkages with bodies registered with the Authority.

“Each hospital will have to fulfil the criteria to be able to get certification by the MTRA,” he said.

Dr Zaman, who has conducted 100 cornea transplants during the last one year at KTH, said that they required infrastructure and new techniques to make the procedures successful.

“So far, most of the transplants are conducted by using old methods in which the rejection chances are more as opposed to the latest techniques where chances of graft rejection are minimal and works for lifetime,” he said.

Dr Zaman said that they had carried out new transplant procedures including ‘deep anterior lamellar keratoplasty’, ‘pre-descemet’s deep anterior lamellar keratoplasty’ and ‘descemet membrane endothelial keratoplasty’. In this surgical technique, the chances of graft rejection are minimal and cornea works for lifetime.

He said that the corneas imported from abroad were donated by elderly people and couldn’t be implanted to the young patients because they could long last and the new techniques could benefit the recipients.

“It is a developing specialty that guarantees restoration of vision to those, who have no vision before. Trauma and pressure cooker blasts are also among the main reason of damaging cornea and ending eyesight,” he said.

Dr Zaman said that they demanded of the government to send ophthalmologists for super specialisation in cornea abroad and put in place modern equipment to facilities the cornea transplantation.

Published in Dawn, June 13th, 2018