Eye bank of asia
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Name of Eye Bank:
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Address:
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Country:
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Contact Person:
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Contact eMail:
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Eye Bank's Website (if any):
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DATA FIELDS FOR AEBA REGISTRY
1. Is your eye bank a :
Government eye bank
Affiliated with a General Hospital or s Specialist Eye Hospital/ Center
NGO or non-profit organization
Private enterprise
Others, specify
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[Other] Is your eye bank a
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2. What type of organ/tissue donation legislation exists in your country?
(more than 1 answer is okay)
Opt-in – pledge or consent required
Opt-out – presumed consent
Coroner’s Law
Others, specify
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Others, specify
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3. Does your country have a National Organ / Tissue donor registry?
Yes
No
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4. How many other eye banks are there in your country (excluding yours)
None
One or more
Please provide names of other eye banks :
(i)
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(ii)
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(iii)
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5. What are your eye bank's working hours?
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6. Please indicate if your eye bank has the following:
Director/s
Yes
No
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If yes, how many
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Technical Staff
Yes
No
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If yes, how many
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Administrative
Yes
No
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If yes, how many
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Others, specify
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7. Source of local donors
(more than 1 answer okay)
Hospitals
Hospices and nursing homes
Funeral homes
Home referrals (community-based)
Others
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Specify
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8. Eye Donations to your eye bank
(* Most recent Year please)
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Total Death Referrals from Source(s)
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Total Number of Procurement
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Total Number of Corneas Utilized
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9. What are the Causes of Death of Donors (Numbers or % OK)
(* Most recent Year please)
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Heart disease
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Cancer
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Trauma
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Cerebrovascular Accident
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Respiratory disease
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Others, please specify
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10. Does your eye bank import tissue from overseas?
Yes
No
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11. If yes, please specify the sources of your overseas tissue (more than 1 answer is okay)
USA
Europe
Asia
Others
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12. Does your eye bank maintain a local patient waiting list?
Yes
No
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13. If yes, how many patients are on the waiting list? (approximate as of to-date okay)
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14. What is the average waiting time for a patient to receive a cornea? (approximate is okay)
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15. How many cornea surgeons make use of your eye bank’s services?
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16. No of Cornea transplants performed in your country / or in your eyebank
(* Most recent Year please)
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17. No of Sclera transplants performed in your country / or in your eyebank
(* Most recent Year please)
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18. Does your eye bank undergo regular audits / inspection?
Yes
No
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19. If yes, who conducts the audit / inspection?
Ministry of Health or other government agency
External agency
Other Eye banks / Eye or Tissue Banking Association
Others
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Please specify
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Captcha
(*)
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