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any Indonesians who suffer from severe corneal disorders face waits of at least six months for new corneas due to a lack of local donors, Indonesian Ophthalmologist Association (Perdami) director Nila Moeloek said Thursday.

“No cornea transplantation can be carried out without first having a healthy cornea from the eye of a suitable donor,” she told The Jakarta Post.

According to the Health Ministry, about 1.5 percent of the population suffers from blindness in both eyes, with the majority suffering from cataracts, glaucoma, diabetes-related retinal disorders, and childhood blindness. About 0.1 percent of total blindness cases are caused by corneal disorders.

At least 100 Indonesians with corneal disorders in both eyes apply for a corneal transplant each year.

Nila, who also chairs the Indonesian Eyes Bank, said improved eye surgery technology in Indonesia meant doctors could now conduct a thorough examination of donated corneas.

Improved technology has also enabled donated corneas to last longer.

“Donated corneal tissue can be stored in a kind of preservative liquid called Optisol GS, which allows it to last for two weeks,” she said, adding that during this time doctors could carry out a thorough examination of donor tissue to check for blood-borne diseases such as HIV, hepatitis or other sexually-transmitted illnesses.

The late Ainun Habibie, the wife of former president Bacharuddin Jusuf Habibie, was instrumental in modernizing eye medicine in the country.

Nila said a lack of cornea donors was a major problem in Indonesia. She said in the last several years the Indonesian Eye Bank had received just 108 locally donated corneal tissues.

“This is very, very few,” she said, adding that most donated corneas used in transplants in Indonesia were imported from Sri Lanka, India, the Philippines and the United States.

Many people refuse to donate their corneal tissue due to cultural and religious factors.

More effort should be made, especially by religious leaders, to assure Indonesian people that donating their corneal tissues is a precious gift for humanity, she said.

“I think we should refer to what was said by Ibu Ainun, “Donating corneal tissue is a divine service,” Nila said.

Doctors can repair the vision of a person with a corneal disorder
by removing and replacing the
damaged endothelium layer of
the cornea.

“During this kind eye surgery, we only remove and replace the endothelium layer of the damaged cornea,” said Ikke Soemantri, an ophthalmologist from Cipto Mangunkusumo Hospital.

The cornea is comprised of five layers: the epithelium, Bowman’s layer, stroma, Descemet’s membrane and endothelium.

Each layer has a specific important function. The endothelium, the extremely thin, innermost layer of the cornea, is essential to keep the cornea clear. People may suffer from blindness if many of their endothelial cells are damaged.

“By replacing their damaged endothelial cells, the endothelium layer can function normally, balancing the flow of fluid into and out of
the cornea,” she said, adding that excessive fluid in the middle corneal layer, or stroma, would cause hazy vision. (ebf)