How many patients can one cornea (corneal tissue) be used for?

One Donor Cornea Can Be Used for Two Recipients

One donor cornea can be used for two recipients through split corneal transplantation techniques, where the anterior and posterior layers are separated and used for different patients with specific corneal pathologies. 1

Split Corneal Transplantation

• A single donor cornea can be divided into an anterior lamellar button (approximately 350 μm thick) and a posterior lamellar button (approximately 150 μm thick) using a microkeratome 1
• The anterior portion can be used for anterior lamellar keratoplasty in patients with anterior corneal stromal pathology 1
• The posterior portion can be used for endothelial keratoplasty (such as DSAEK) in patients with endothelial dysfunction 1

Clinical Outcomes of Split Corneal Transplantation

• Studies demonstrate high success rates with this approach:
  • 83.3% of anterior lamellar keratoplasty recipients achieve best-corrected visual acuity >20/60 1
  • 75% of endothelial keratoplasty recipients achieve best-corrected visual acuity >20/60 1
• No significant increase in intraoperative or postoperative complications has been observed with this technique 1

Importance in Addressing Corneal Blindness

• This approach effectively doubles the availability of transplantable corneal tissue, which is particularly valuable in regions with donor tissue shortages 1
• Appropriate case selection is critical to ensure optimal outcomes for both recipients 1

Quality Assurance and Safety Considerations

• Tissue processing must be performed in controlled environments to minimize the risk of contamination 2
• Processing environments should meet minimum standards of conventional operating rooms (<25 colony-forming units per 90-mm settle plate per 1-hour exposure) 2
• Rigorous donor screening is essential to prevent disease transmission, as corneal tissue can potentially transmit various infectious agents 3

Limitations and Considerations

• Not all donor corneas are suitable for splitting - tissue quality, age, and other factors must be considered 1
• Specialized equipment (microkeratome) and surgical expertise are required 1
• Careful patient selection is necessary to match the appropriate corneal layer with the specific pathology 1

Risk Management

• Long-term record maintenance and effective tracing capabilities are essential for vigilance and safety monitoring 3
• International standardization of adverse event definitions and unique donor identification systems are increasingly important for cross-national tissue exportation 3
• The risk of disease transmission remains extremely low with proper screening protocols 4