AN EYE BANKING PROGRAM FOR SELECTING DONOR CORNEAS FOR SURGICAL DISTRIBUTION

Since fewer donated corneas have become available for surgery, we soug ht to chart the reasons to exclude them for surgical use over time. Th ose excluded from surgical use (1991-1994) were plotted using an algor ithm based on the reasons for exclusion. Four general categories (univ ersal contraindications [UC], national/local medical criteria [NLMC], serology, and morphology) yielded 13 possible areas. UC and NLMC exclu sions for 1993-1994 were higher compared with 1991 and 1992 (p < 0.001 ). The proportion of corneas excluded for serological reasons decrease d (p < 0.001) from 1991 to 1994. Exclusions due to morphology remained the same for all 4 years (p = NS). NLMC eliminate older donors but al so exclude younger donors before the tissue reaches the eye bank (p > 0.001). Three of four of the youngest tissues (< 30 years) are used fo r surgery, whereas one of five of the oldest (> 70 years) is used. A q uality control algorithm provides a heuristic and logical paradigm for noting changes from year to year. Heightened regulation has counterac ted many gains in corneal donation fostered by favorable laws.