Efficacy of Routine Notification and Request on reducing corneal transplantation wait times in Canada

Abstract

Objective: To determine whether the implementation of Routine Notification and Request (RNR) has been effective in increasing the amount of donor corneal tissue available and reducing wait times for corneal transplant (CT) surgeries. Design: Survey of the CT surgeons and eye banks in Canada. Participants: CT surgeons and representatives of the 10 eye banks in Canada. Methods: Voluntary, anonymous questionnaires were distributed between May 1 and September 30, 2006. Results: Following the implementation of RNR, 3 eye banks had an increase in the amount of corneal tissue available: Manitoba, 81% (from 42 tissues in 2004 to 76 tissues in 2006); Ontario, 25% (from 1304 tissues in 2005 to 1626 tissues in 2006); New Brunswick, 129% (from 86 tissues in 2005 to 197 tissues in 2006). British Columbia, where RNR was implemented in 1999, had a 6% increase (from 766 in 2005 to 812 in 2006). There has been a significant decrease in wait times from the time of diagnosis by CT surgeons to the time of surgery in British Columbia (from 48±18 weeks in 2004 to 39±20 weeks in 2006), Manitoba (from 82±56 weeks in 2004 to 32±23 weeks in 2006), Ontario (from 82±56 weeks in 2004 to 31±34 weeks in 2006), and Nova Scotia (from 44±12 weeks in 2004 to 32±28 weeks in 2006). Conclusions: RNR has been effective in increasing corneal tissue availability and decreasing wait times in provinces where it has been implemented. We recommend similar legislative changes to be considered in those provinces where corneal tissue shortage is delaying the availability of CT surgery.