In recent years, the supply of corneas has faced increasing pressures, reaching a breaking point and resulting in a rise in surgery cancellations in 2025.
In this context, Héma‑Québec initiated an open dialogue with the clinical community to share a common understanding of the situation and identify realistic avenues for improvement.
Three consultation sessions were held on February 18, 2026, and April 1, 2026, following an invitation extended to all cornea specialists in Québec. These discussions supported a constructive reflection on the evolution of the current model.
Overview of Supply
Héma‑Québec has operated the Québec Human Tissue Bank since 2001 and has been responsible, since 2008, for the procurement and allocation of ocular tissues, in collaboration with the province’s two eye banks. The model implemented aimed to reduce waitlists and ensure that tissue availability would no longer be a limiting factor for surgeries.
Target preparation time for corneas distributed by Héma‑Québec: 7 to 10 days
However, annual demand for corneas has increased from approximately 600 to over 1,000 transplants, with sustained growth since 2022. Although local production has increased in recent years, a decline in self-sufficiency has been observed since 2024, leading to greater reliance on imports and increased vulnerability during periods of high demand.
Key Issues Identified
Discussions with the clinical community highlighted several shared observations:
- The short shelf life of corneas (approximately a four-day usage window) limits any ability to build a safety inventory.
- Significant and sometimes unpredictable variability in weekly demand complicates supply planning.
- Donor qualification is becoming increasingly complex due to the high rate of ocular surgery in Québec, while rejection rates remain elevated.
- Availability of corneas by type (DSAEK / DMEK) varies and depends on donor characteristics.
- Organizational constraints within hospital centers (operating room availability, vacations, conferences, staffing shortages) directly affect surgical planning capacity.
Together, these factors expose the system to intermittent shortages, potentially resulting in postponed or cancelled surgeries.
Clinical and Operational Challenges Raised by the Network
Surgeons emphasized:
- The significant impact of last-minute cancellations on patients;
- The difficulties associated with short-term operating room scheduling;
- The need for better visibility on high-risk periods;
- The importance of maintaining equitable distribution of tissues across centers while preserving clinical prioritization of patients.
Explored Areas for Collaboration
In a continuous improvement perspective, several avenues were discussed:
- Improving advance sharing of information (surgical schedules, periods of reduced activity);
- Strengthening two-way communication between Héma‑Québec and clinical teams;
- Exploring ways to reduce demand variability in order to smooth weekly peaks;
Continuing initiatives to optimize donor identification and overall supply performance.
Conclusion
The consultation sessions confirmed that current challenges in corneal supply are multifactorial and require shared responsibility between Héma‑Québec and the healthcare network. Héma‑Québec reiterates its commitment to working closely with clinical and administrative teams to gradually adapt practices, reduce impacts on patients, and ensure optimal use of available tissues.
Upcoming Event
| Visit us at the Héma‑Québec booth at the upcoming Canadian Ophthalmological Society (COS 2026) Annual Meeting June 19–20, 2026 | Palais des congrès de Montréal |
Interested in learning more about corneal allogenic intrastromal ring segments (CAIRS), soon to be distributed by Héma‑Québec? Don’t miss the hands-on workshop taking place on Saturday, June 20, from 1:45 p.m. to 3:30 p.m.
Contact Us
Our teams remain available to answer your questions:
Customer Service Team: tissus@hema-quebec.qc.ca
Management Team: tissushumains@hema-quebec.qc.ca