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      Clearing the path to vision restoration: an analysis of attitudes and associated factors towards cornea donation in Syria

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          Abstract

          Objective

          This study aims to assess attitudes and associated factors towards cornea donation among visitors of a main public hospital in Damascus. Findings of this study can contribute to the development of effective donation campaigns and applying cornea donation in Syria.

          Methods

          This cross-sectional study included individuals who were above 18 years old and were visitors of Al-Mouwasat University Hospital in Damascus, Syria. Data were gathered using a questionnaire administered through face-to-face interviews with the participants. A validated questionnaire was used and consisted of three sections: demographic information, awareness assessment and evaluation of participants’ attitudes towards corneal donation. Associations between participants’ demographics and variables were tested using χ 2 test, and a p value of <0.05 was considered significant.

          Results

          637 participants were randomly interviewed. 70.8% of the sample were female and 45.7% have heard about cornea donation. 68.3% of the participants accepted donation of their cornea after death, but this decreased to 56.2% when it comes to donation from relatives after their death. The main reasons for refusing and accepting cornea donation were religious beliefs (10.8%) and intention to help others (65.8%), respectively. Women were more likely to accept donation after death than men (71.4% vs 60.8%, p=0.009). Finally, acceptance of cornea donation would increase if participants lived in a more developed country (71.7% vs 68.3%).

          Conclusion

          Despite the high willingness, corneal donation in Syria is still not enough. Corneal donation requires an ensured donation system that supports and organises the processes, a simplified education about the importance of donation, and clarifying the right instructions of religion.

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          Most cited references29

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          Blindness in the eastern Mediterranean countries.

          K Tabbara (2001)
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            Corneal transplantation activity over 7 years: changing trends for indications, patient demographics and surgical techniques from the Corneal Transplant Epidemiological Study (CORTES).

            This study aims to examine evolving indications and changing trends for corneal transplantation in Italy. Corneal transplantations performed with donor tissues distributed by the Veneto Eye Bank Foundation between 2002 and 2008 were prospectively evaluated. Of the 13,173 keratoplasties performed on 11,337 patients, 10,742 (81.5%) were penetrating (PK), 1644 (12.5%) were anterior lamellar (ALK), and 787 (6.0%) were endothelial (EK). Keratoconus (42.5%), regraft (18.9%), and pseudophakic bullous keratopathy (PBK, 11.9%) were the leading indications for PK, with keratoconus (69.6%) and regraft (6.5%) showing higher indications for ALK, whereas pseudophakic bullous keratopathy (50.1%) and regraft (18.7%) were the major indications for EK. There was an overall decrease observed in corneal grafting for keratoconus (P = .0048) and an increase for PBK (P = .0653) and regrafting (P = .0137). These indications differed by age and gender. The number of keratoplasties over 7 years was stable (P = .2394), although the annual number of PKs declined by 34.0% (P = .0250), ALKs began to rise from 2005 (P = .0600), whereas EKs showed a huge growth, with their number tripling in 2007 and further doubling in 2008 (P = .0004). Leading indications for keratoplasty showed similar data that have been reported elsewhere for Western countries over the past few decades, albeit with a higher percentage of keratoconus. However, the overall number of keratoplasties for keratoconus was in decline, whereas regraft keratopathy and PKs increased due to the application of the newer surgical techniques for corneal grafting. This highlights an important shift in managing corneal diseases toward the application of selective and more conservative surgeries and changes in indications in corneal transplantation.
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              Awareness and attitudes toward corneal donation: challenges and opportunities

              There is a severe shortage of donor corneas available worldwide for transplantation, with the number of patients in need of transplant greatly exceeding the number of cornea tissues available. Understanding awareness and attitudes about corneal donation worldwide is a critical step toward addressing this shortage. In this review, awareness of corneal donation and reported willingness to donate are summarized from 55 published studies across 13 countries. In general, many more respondents indicated positive attitudes toward eye donation and willingness to donate their eyes than the number of respondents who have pledged their eyes for donation, suggesting an unrealized potential of additional donors. Specifically, of 38,851 respondents across all included studies, 52% endorsed a willingness to donate their eyes after death, yet only 5% reported being a pledged donor. The most commonly cited reason for not being a registered eye donor was lack of awareness about eye donation. The disconnection between the large number of people who expressed willingness to donate and the scarcity of individuals who have pledged their eyes for donation could be addressed through educational media campaigns, collaborations with medical personnel, partnerships with grief counselors and religious leaders, use of social media, and educational sessions with medical students and staff.
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                Author and article information

                Journal
                BMJ Open Ophthalmol
                BMJ Open Ophthalmol
                bmjophth
                bmjophth
                BMJ Open Ophthalmology
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2397-3269
                2023
                29 May 2023
                : 8
                : 1
                : e001290
                Affiliations
                [1 ]departmentFaculty of Medicine , Ringgold_251087Damascus University , Damascus, Syrian Arab Republic
                [2 ]departmentDepartment of Ophthalmology , Ringgold_125592Al Baath University , Homs, Syrian Arab Republic
                [3 ]departmentFaculty of Medicine , Ringgold_125594University of Aleppo , Aleppo, Syrian Arab Republic
                [4 ]departmentDepartment of Ophthalmology , Ringgold_108042Damascus University , Damascus, Syrian Arab Republic
                [5 ]departmentFaculty of Medicine , Ringgold_125592Al Baath University , Homs, Syrian Arab Republic
                Author notes
                [Correspondence to ] Dr Jameel Soqia; jameelsoqia@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-3758-0489
                http://orcid.org/0009-0003-3176-6172
                http://orcid.org/0000-0003-4848-6719
                http://orcid.org/0000-0002-1800-2050
                Article
                bmjophth-2023-001290
                10.1136/bmjophth-2023-001290
                10230974
                37278433
                121e5c07-b239-4e60-a35f-afb20ec12a27
                © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 14 March 2023
                : 16 May 2023
                Categories
                Original Research
                1506
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                cornea
                cornea

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