Eye Banking in Asia: Experiences and Challenges in the Post-pandemic Era

Eye banks provide essential corneal tissue for transplantation. Unfortunately, they were greatly impacted during the pandemic. In the “Cornea, External Eye Diseases and Eye Banking Symposium,” speakers discussed the challenges of eye banking in Asia in the post-pandemic era and ways to overcome the shortage of donor tissue.  

Eye banks help cure blindness by providing quality donor eye tissue for sight-saving cornea transplant procedures, medical education, and ophthalmic research. Nearly 185,000 corneal transplants are performed each year in over 115 different countries. And of the corneal grafts used worldwide, 87% are procured from donors within the same country, while 27 countries (1.2% of corneal transplants) rely solely on imported corneas to supply their need for corneal allografts.1 

Post-pandemic recovery  

As the world emerges from the effects of the pandemic, eye banks are still recovering from the impacts of lockdowns and the inability to harvest eyes from donors, among other challenges. 

“The COVID-19 pandemic has impacted eye banking and cornea transplantation in the Asia-Pacific, especially with the temporary cessation of eye banking services and limiting services to emergencies only. This has led to an overall reduction in the number of cornea transplants,” said Assoc. Prof. Marcus Ang from Singapore in his presentation entitled Impact of COVID-19 on Cornea Transplantation in the Asia Pacific — An Eye Bank Survey. He collated data from eight out of 12 eye banks in the region, in the first-of-its-kind survey in the Asia-Pacific. 

Meanwhile, Dr. Ma. Dominga “Minguita” B. Padilla from the Philippines spoke on Reviving Eye Banking in the Philippines while Emerging from the Pandemic. According to Dr. Padilla, peculiar to the Philippines, 86% to 93% of cornea donors from 1995 to 2021 were medico-legal (coroner’s cases), 80% were 40 years old or younger, and the cause of death for 85% of them was trauma. However, that came to a sudden halt when the government of the Philippines enforced one of the longest pandemic lockdowns in the world. 

“Currently, one of the strategies employed in the Philippines is to revive the Funeral Home Retrieval Program, renewing mechanisms of action (MOAs) with hospital partners, and entering into MOAs with new hospitals and local health units (LGUs),” she added.

Meanwhile, according to Prof. Namrata Sharma from India, in her presentation, Eye Banking in the Post-Pandemic Era — Lessons Learnt, the COVID-19 pandemic has presented many challenges for eye banking, including decreased supply of donated eyes, increased risk of infection, reduced capacity for processing, limited access to hospitals, and reduced funding. 

“By enhancing infection control measures, adopting technology, and increasing collaboration and donor education, eye banks can continue to provide safe and effective services to those in need. Important lessons learned will help the sector adapt and evolve in the post-pandemic era,” said Prof. Sharma.

Addressing the shortage of donor corneas

At present, the global need for corneal donor tissue significantly exceeds the available supply.

“With an estimated 12.7 million people waiting for a corneal transplantation, only one in 70 of the needs are met worldwide,” said Prof. Sharma. She further added that 55% of all corneas for transplantation were procured in the US and India. 

“Penetrating keratoplasty (PK) remains the most common type of transplant performed outside of the US despite the decrease in the proportion of PK procedures and increase in endothelial keratoplasty (EK) volume. However, indication data for corneal transplantation internationally is missing in over 60% of cases,” said Dr. Fasika Woreta from the United States.

So, what can be done to address the needs of those waiting for corneal transplants due to the low supply of donors? Dr. Season Yeung from Australia discussed Dual-Purpose Donor Cornea for Separate Anterior and Endothelial Keratoplasty.

“Splitting a donor cornea for a combination of anterior lamella keratoplasty (ALK) and EK seems to be a possible solution to the shortage of donor tissue. Microkeratomes have allowed the preparation of a corneal anterior lamella suitable for ALK and a posterior lamella suitable for Descemet stripping automated endothelial keratoplasty (DSAEK),” explained Dr. Yeung.

In his presentation, Multiple Use of Corneal-Scleral Tissues — Issues and Dilemmas, Prof. Dr. Mohtar Ibrahim from Malaysia also shared his experiences on the multiple uses of corneal-scleral tissue due to the limited availability of the said tissue for transplantation.  

In the coming years, efforts towards improvement in eye banking will ensure higher standards of both the quality and quantity of corneal tissue for rehabilitation of corneal blind patients.2 


  1. Aggarwal H, Gupta N, Garg P, Sharma M, Mittal S, Kant R. Hospital Cornea Retrieval Programme in a startup eye bank – A retrospective analysis and lessons learned. Indian J Ophthalmol. 2021;69(6):1517-1521.
  2. Vanathi M, Tandon R, Panda A, Vengayil S, Kai S. (2007). Challenges of eye banking in a developing world. Expert Rev Ophthalmol. 2007;6(2): 923-930

Editor’s Note: The 38th Asia-Pacific Academy of Ophthalmology Congress (APAO 2023) was held on February 23 to 26 in Kuala Lumpur, Malaysia. Reporting for this story took place during the event. A version of this article was first published in Issue 2 of the APAO 2023 Show Daily.

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