This document provides instructions for donor corneal recovery. It describes the pre-recovery procedures like checking instruments, obtaining consent, and examining the donor. It then details the donor preparation process which includes cleaning the face and eyelids with povidone-iodine. Finally, it explains how to perform the in situ corneal excision by making incisions in the sclera and conjunctiva and carefully removing the corneal-scleral button to avoid damage to the cornea or perforating other structures. Blood samples are also collected from the donor to screen for infectious diseases.

1. DONOR CORNEAL RECOVERY
Dr Hemant Kamble
Senior Resident
Natonal Eye Bank
Dr. Rajendra Prasad Centre For Ophthalmic Sciences
New Delhi

2. 1. Pre recovery procedures
2. Donor preparation
3. In situ corneal excision
4. Cornea evaluation & preservation
5. Scleral processing & preservation
6. Drawing of blood sample from the donor
7. The screening of donor blood sample for HIV,
Hepatitis B surface antigen, Hepatitis C and
Syphilis

3. Pre Recovery Procedures

4. Pre Recovery Review
 Check sterile instrument kits
 Documentation forms-
Donor call initial information sheet, consent
forms, donor information sheet, donor eye
medical particulars.

5. Consent for Ocular Tissue Recovery
 Correct individual
 Specific tissues for recovery
 Authorization for blood collection
 Review medical records and complete medical
history

6. Identify the donor
 Match the donor name, tags.

7. Worksite Preparation
 Identify a suitable place
 Clean with disinfectant
 Wear gloves and mask

8. Gross Inspection of the Donor
 Evidence of high risk behaviour
 Torch light examinationof donors eyes and
periorbital area
 Blood sample

9. Donor preparation

10. Face cleaning
Lid margin preparation
Conjunctival Prep
Globe Prep
Lid and Face Prep

11. Donor face cleaning
 If gross debris present
 Non sterile gloves
 Irrigate donor’s eyes and face with sterile
balanced salt solution
 Non sterile 4*4 inch cotton squares to remove
debris

12. Lid margin preparation
 CTA dipped in 5% povidone iodine to scrub UL
margins and lashes
 Similarly for LL
 Repeated 3times
 Repeat for other eye

13. Conjunctival Prep
 5% PI dipped CTA swept through lower
conjunctival fornix from lateral canthus towards
nose
 Similarly for upper fornix
 Repeat for other eye

14. Globe Prep
 1.5cc of 5% PI is taken in sterile syringe
 Upper lid rolled back
 0.75cc PI solution poured
 Done similarly for LL and other eye.

15. Lid and Face Prep
 5% PI used to prep skin and facial area from scalp
to baseline of nose
 Starts from lid margin and works in a circular
pattern outward
 Repeated for each eye two more times
alternately
 Drape the eye
 Insert a speculum taking care to avoid
scratching the cornea.PICSBarraquer s eye
speculum.jpg

16. Corneo Scleral Rim Excision

17. Pre requistes
 Strict aseptic precautions
 To be performed by individuals specifically
trained in in-situ retrieval by RMPs trained in
removal.

18. Conjunctival peritomy
 Small clawed forceps and conjunctival scissors
to lift and cut the conjunctiva at the limbus 360
degrees.PICSForceps.jpgPICSConjunctival
scissors.jpg
 Relaxing cuts in the conjunctiva radially to
accomplish this.

19.  Exposed sclera is carefully scraped from the
limbus outward with a scalpel blade (#11 or #15)
to remove all remaining conjunctival tissue.

20. Scleral Incision
 Second scalpel with a #15 blade and small
clawed forceps to make an incision through the
sclera 2 mm to 4 mm from the limbus.PICSBard and
Parker.jpg
 Cut all the way through the sclera without
perforating the choroid
 Scleral incision continued 360 degrees using
corneal section scissors and small tissue forceps
to stabilize the posterior aspect of the scleral
incision if necessaryPICSCastroviejo Scissors.jpg

21. AVOID
 Perforating the choroid
 Breaking into the anterior chamber
 Vitreous loss
 Any deformation of the cornea’s normal
curvature.
 Trauma to the cornea during scissoring

22.  Complete the corneal removal by using one pair
of small smooth dressing forceps to hold the
scleral rim stationary and a second set of small
smooth dressing forceps or an iris spatula to
gently push the ciliary body-choroid downward
and away from the corneal-scleral button.

23. THANK YOU