Almost no donations are going into Malta’s eye bank, according to one of Malta’s two surgeons who perform cornea transplants.

Ophthalmic surgeon Andre Grixti said the last cornea transplant he performed was in June. 

Over 20 patients under Grixti’s care are waiting for a new cornea, while a total of 45 are on the waiting list. 

“There is definitely a lack of awareness from the public about how important cornea donation is and how much it would help other people,” he said. 

“Any person can be a cornea donor as the cornea does not need to be matched provided that the person does not have specific diseases,” Grixti said.

Hepatitis, HIV and some cancers prevent people from donating their corneas after they die, he said. 

The cornea is the outermost, clear layer of the eye and its main function is the refraction of light and focusing.

Andre Grixti is one of Malta’s two cornea transplant surgeons. Photo: Andre Grixti

Grixti said eligible candidates for a cornea transplant could have had an eye injury, have an abnormally shaped cornea, have weakened cornea cells (fuchs endothelial dystrophy), have grain built up in the cornea (granular dystrophy) or might have criss-cross lines develop in that part of the eye (lattice dystrophy).

He clarified that cornea transplants do not help eye conditions that affect other parts of the eye, such as glaucoma or macular degeneration.

Changing to an opt-out system would help increase the number of donors as right now people need to make the effort to actively sign up to be donors, he said. 

PN MP Ivan Bartolo last week filed a private members’ bill to do that and Health Minister Jo Etienne Abela said he supports the initiative. 

Grixti said Malta also needs more transplant coordinators – healthcare professionals who act as go-betweens for patients, professionals, and potential donors.

According to Maltese law, transplant coordinators are tasked with approaching the next of kin of a deceased person to ask whether they consent to organ donation. 

To tackle Malta’s cornea shortage, St Thomas Hospital, a private hospital in Qormi, will begin performing transplants with corneas from abroad after entering a strategic partnership with a European tissue bank.

Grixti will be the surgeon in charge. 

A theatre at St Thomas Hospital, where Grixti will operate.  Photo: St Thomas Hospital

“Following a thorough regulatory process, we are proud to announce that St Thomas Hospital has entered a strategic partnership with Banc De Sang Teixits, a leading European tissue bank,” the hospital’s director Ryan Buhagiar said. 

Based in Barcelona, Spain, the organ bank will be supplying donated corneas to patients at St Thomas Hospital, he said.

“We understand the profound impact that vision loss can have on an individual’s life, and we are committed to offering an affordable, safe, and effective solution,” Buhagiar said.

The hospital director said the first transplant is scheduled to take place in the coming weeks. 

Buhagiar said the new cornea transplantation service is licensed to conduct keyhole cornea transplants.

Grixti explained that the keyhole transplant (known as DMEK) replaces the inner layer of the cornea, for example, when the inner layer is damaged during other surgeries like cataracts or by inherited disease or infection.

At St Thomas he will be also performing another type of partial transplant known as DALK. 

“It replaces the outer layer and is used when the outer layers are damaged by infection, keratoconus (abnormal shape of the cornea) or inherited diseases like cornea dystrophy,” Grixti said. 

These transplants lead to higher acceptance rates from the recipient’s body and a faster recovery time, he said.

Grixti will also be performing full cornea transplants at the hospital.

CAPTIONAndre Grixti is one of Malta’s two cornea transplant surgeons. Photo: Andre Grixti