Data for 2024-25 shows that 51,249 corneas were donated in India, meeting only a quarter of the projected need of about 1,00,000 corneas annually. The reason for this is the utilization rate is 50% at best, and the actual number of transplants varies between 25,000 and 30,000.
Why is this happening? The reason that much of this gift of vision does not reach the operating table is that the donor corneal tissue was not tested or processed in a timely manner. Other reasons include improper collection and storage, and the decrease in endothelial cell density that occurs as donors age. While some of these factors may not have an immediate or implementable solution, what can be improved is timing and logistics.
Understanding the Corneal Restoration Procedure
Retrieving corneas after death is a race against time. First, there is a six-hour period after death during which the cornea should ideally be removed. This may vary in different weather conditions. For example, in winter and the rainy season this time can also be 6-8 hours. A second, lesser known factor is the clock that starts when corneal tissue is in storage. Most Indian eye banks still store corneas in McCarey-Kaufman (MK) medium, which keeps the tissue usable for about 72 hours. Some use newer intermediate media such as Optisol-GS or Cornisol, extending this window to 10–14 days.
Doctors from the Dr Rajendra Prasad Center for Eye Sciences (RPC) at AIIMS Delhi, along with engineers from IIT Delhi, are testing a way to recycle discarded donor corneas using a bioengineered graft. Corneas that do not meet transplant standards due to low cell counts or minor damage can be stripped of living cells and made into a reusable scaffold for patients with superficial corneal damage. While the trials are still in a very early stage, they point to a future in which fewer donations end up being thrown away.
However, until we figure out a way to reuse expired corneas, the window will close and the tissue will have to be thrown away. 72 hours or even two weeks is not a lot of time to test the cornea, find a suitable patient, and move the tissue from the eye bank to the operating room. Compounding the problem, nearly 70% of the total collection and use of corneas is concentrated in just six states – Andhra Pradesh, Telangana, Gujarat, Karnataka, Maharashtra and Tamil Nadu. A cornea obtained in a small town without waiting for a local surgeon may become unusable during transport to the town where it is available.
What can you do
Extending the shelf life is the first step. Eye banks must move from using MK media to intermediate media and eventually to organ culture storage, which in some countries is used to keep corneas viable for a month. This helps buy valuable time to find the right recipient rather than the closest one. A national real-time inventory linking every eye bank directly to surgeons in 50 cities could allow corneas that expire in Kozhikode to be offered on a waiting list in Chennai before they are discarded.
Because fresher corneal tissue withstands testing and transplantation better, the next focus should be on reducing the time between death and retrieval, and retrieval and preservation. Hospital corneal extraction programs, in which hospitals notify eye banks in advance of deaths and trained counselors reach out to grieving families, help reduce this time factor and outperform voluntary at-home sample collection. Expanding this model to more hospitals, rather than relying on a push for only the two-week eye donation period, will help improve cornea utilization.
Quality assurance (QA) programs at eye banks will also help effectively reduce reject rates even as the volume of donor corneas increases. The study found that the reject rate decreased from approximately 40% to 30% due to improved donor acquisition processes and improved tissue recovery through effective adherence to quality assurance programs.
While we approach the issue of donation by raising awareness and educating people about the benefits of organ donation, we must also take care of delivery with more efficient chemical storage facilities, faster hospital protocols and a database that shows in real time exactly which corneas are about to run out, who needs them and where.
(Dr. Suvira Jain is Medical Director, ASG Hospital Limited, Worli, Mumbai. Suvira.Jain@asgeyehospital.com)
Published – Sep 09, 2026 02:37 PM IST.