Maxine Blackman has undergone sight-saving corneal transplants on both eyes. The Herald’s health reporter Diana Prince reports from the operating theatre to highlight the urgent need for more donors.

MAXINE Blackman does not know the two men who saved her sight.

Her corneal transplants were made possible by donors who pledged to give their organs after death.

The 71-year-old widow, of Plympton, said it is the "greatest gift" they could have offered.

She has undergone NHS operations on both eyes to replace the delicate inner lining of her corneas – the 'clear window' which lets in and focuses light.

The first was on her right eye in 2007, when she was one of the first patients in the country to have a new type of transplant being pioneered in Plymouth.

The second was yesterday, after the sight in her left eye also deteriorated.

Maxine has Fuchs' corneal dystrophy, a disease which causes progressively blurred vision.

She describes is as "trying to look through a very cloudy bathroom mirror".

Maxine and consultant ophthalmic surgeon Mr Nabil Habib allowed The Herald into theatre at the Royal Eye Infirmary (REI) to highlight a need for donors.

Urging more people to sign the Organ Donor Register, she said: "Without the expertise of Mr Habib, the donors and their families, I wouldn't be able to see. Life would be very different for me.

"The only thing I know about the first donor was that he was a 72-year-old man.

"It is the greatest gift you could ever give, without even knowing who you are giving it to. I am so grateful.

"I would have liked to be able to thank his family. They have to agree to the donation as well."

Maxine, a grandmother of three, arrived at the REI in Mutley at 7.45am to prepare for her second 'endothelial corneal transplant'.

It involves replacing only the innermost layer rather than the entire cornea, making the procedure is less invasive and safer.

The REI was the first hospital in the country to carry out the surgery using automated equipment.

It is still the only centre south of Bristol to perform the highly-specialised operation – about 30 times a year – and takes complex cases from around the country.

Anaesthetists prep Maxine by injecting a local anaesthetic under her left eye.

She will stay awake throughout the hour-long procedure.

As Mr Habib scrubs up, he explains: "We won't cut her cornea at all. We just remove a layer from the back and replace it with another layer through a small incision at the side of her eye."

The replacement cornea was transported from the Bristol 'eye bank' the night before.

It was donated by a 65-year-old man who died of a brain haemorrhage in early March, says Mr Habib. Corneas can be donated up to 24 hours after death and stored for four weeks.

Mr Habib takes the replacement cornea – a clear disc still surrounded by part of the white of the eye – from a plastic container and locks it on to a metal stand.

After careful measuring, he shaves off three fifths of the outer layer using a high-tech razor.

He cuts the white from the cornea using what he describes as a tiny "cookie cutter".

The result is a tiny disc less than 1cm in diameter, which appears as thin as a piece of cling film.

At 9.45am, Maxine is on the operating table covered with a blue sheet with a gap over her left eye which is clamped open.

Mr Habib works through a ceiling-mounted microscope. Classical music plays while he works.

As he cuts her eye with a diamond-tipped scalpel, the surgeon asks his patient: "Do you like the music?"

She replies: "Very much."

Mr Habib stains the damaged layer – the 'endothelium' – of cornea with blue dye and removes it through the incision.

The replacement tissue is placed on a tiny spoon-like instrument and placed into the eye, again through the cut. It is pulled in to place by a thread thinner than a human hair.

In order to make it stick to the back of the cornea, an air bubble is injected to fill the front of the eye.

Maxine must stay on her back for as much as possible in the following 24 hours to ensure the bubble keeps the new cornea in place.

After returning home at around 4.30pm yesterday, she will today return to the REI today to check the tissue has anchored. Her sight should return to normal.

EYE DONATION: factfile

Last year 2,249 people donated their eyes for use after their death but there is still a shortage of corneas in the UK.

The cornea is the clear tissue at the front of the eye that lets in light and helps focus it on the retina.

There is a shortage of approximately 500 corneas each year. The number of requests to NHS Blood and Transplant organisation that cannot be met has increased owing to increased demand brought about by advances in transplantation.

Ninety per cent of transplants use corneas stored in ‘eye banks’ in Bristol and Manchester, which use special techniques to store them for up to four weeks.

The NHS Organ Donor Register invites people to specify which organs they wish to donate.

At the end of March 2010, 87 per cent of people joining the register indicated a willingness to donate all organs and tissue. Only 9.3 per cent declined to offer their eyes.

More information about organ donation and the NHS Organ Donor Register is available on 0300 123 23 23 or at the NHSBT website www.organdonation.nhs.uk