This instrument is the Health Insurance (Quality Assurance Activity – Australian Corneal Graft Registry) Declaration 2025

(1) Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

Commencement information
Column 1	Column 2	Column 3
Provisions	Commencement	Date/Details
1. The whole of this instrument	The day after this instrument is registered.

Note: This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

(2) Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3 Authority

This instrument is made under subsection 124X(1) of the Health Insurance Act 1973.

4 Repeal

This instrument is repealed when it ceases to be in force in accordance with subsection 124X(4) of the Health Insurance Act 1973.

5 Schedule

The quality assurance activity described in the Schedule to this declaration is, to the extent that the quality assurance activity relates to health services provided in Australia, declared to be a quality assurance activity to which Part VC of the Health Insurance Act 1973 applies.

Schedule 1—Description of quality assurance activity

1 Name of activity

The name of the quality assurance activity is Australian Corneal Graft Registry

2 Description of activity

The Australian Corneal Graft Registry (ACGR) quality assurance activity objective is to collect patient and surgeon data relating to corneal transplantation surgery in Australia. These data are aggregated and analysed to provide de‑identified performance information back to ophthalmic surgeons, Eye Banks, the international transplantation community, the Australian Government via DonateLife, the National Organ and Tissue Donation and Transplantation Authority, the Medical Services Advisory Board (MSAC) and other interested parties regarding the outcomes of corneal graft procedures and factors that may positively or negatively affect outcomes after the procedure. Through provision of these results, informed choices can be made for providing optimal treatment to recipients of corneal grafts.

The ACGR is conducted by Flinders University staff who collect information on a voluntary basis from eye banks, ophthalmic surgeons, and other health professionals. The information collected includes demographic data about corneal graft recipients, limited data about cornea donors, and information about the surgical procedures performed. Information from follow-up appointments is collected at 12–18-month intervals after the surgery.

An Advisory Board, consisting of clinicians and scientists, oversees the management of the registry. The methods employed by the ACGR are overseen, and reviewed regularly, by the Southern Adelaide Human Research Ethics Committee. The ACGR collects nationwide data relating to corneal transplantation. The ACGR currently contains over 47,000 records of corneal transplants. The ACGR analyse this data on corneal transplantation surgery, on the outcomes of corneal transplantation, and the factors that may positively or negatively affect transplant outcomes.

At regular intervals of 12 to 36 months, follow-up postal information regarding transplantation surgery outcomes is sought from the surgeon, or from an alternative health practitioner caring for the corneal transplant recipient. This post-surgical follow up continues to be sought until the time of graft failure, recipient death, or loss to the recipient.

Graft recipients provide consent to their surgeon for data to be submitted to the ACGR, as well as for a minimum dataset to be submitted to the Australian Institute of Health and Welfare (AIHW) at 5-year intervals, for linkage with the National Death Index. Recipient consent is indicated initially on the registration form and can also be withdrawn from the registry at any time. Outcomes from the ACGR are always reported in a de-identified, aggregated form.

Since previous declaration, the ACGR has included further datasets related to new forms of corneal transplantation and is moving towards more secure online submission of register data to encourage registry participation. Surgeons have informed the ACGR that paper-based forms are a barrier to participating and it is expected that online submissions will increase the graft registration rate substantially, from the current 80-85% participation rates.