To evaluate the current cornea donation awareness of tissue donors in the city of Nanjing

China. Methods Altogether 2000 registered tissue donors in the Red Cross Eye Bank of Nanjing by the end of 2010 and 2000 control residents of Nanjing in February to June 2011 were randomly selected to participate in our field questionnaire survey. The questionnaire consisted of questions regarding the understanding of cornea dona-tion

the attitude toward cornea donation

and attitude toward legislation and free donation. The awareness of cornea donation between the registered tissue donors and residents was compared. Related factors of the willing-ness to donate corneas and to become a tissue donor were evaluated with univariate and multiple logistic regression analysis. Results A total of 1867 (response rate: 93.4%) tissue donors and 1796 (response rate: 89.8%; effective questionnaires: 1697) residents participated in this survey. For the questions about the knowledge of cornea donation

90.3% tissue donors (residents: 78.9%) knew that donated corneas could be used for transplantations; 71.2% tissue donors (residents: 47.6%) knew that the appearance would not be destroyed after cornea donation; 70.7% tissue donors (residents: 20.0%) knew the formalities to become a cornea donor. For attitude toward cornea donation

82.2% tissue donors (residents: 45.1%) were willing to donate corneas or eyeballs after death; 84.0% tissue donors (residents: 30.2%) had discussed with their families about donation; 85.1% tissue donors (res-idents: 24.8%) supported their families' or friends' cornea donation. For attitude toward legislation and free donation

88.3% tissue donors (residents: 61.3%) approved of legislation to regular cornea donation; 72.2% tissue donors (residents: 38.8%) thought that cornea or organ donation should be gratis. The difference between two groups was significant (P<0.001). However

some tissue donors did not know cornea donation well

some even opposed the legislation of cornea donation and free donation protocol. For the factors influencing the willingness to donate corneas

population was the most relevant factor (P<0.001)

since tissue donors were more willing to donate corneas than residents. Other significantly related factor were age

gender

occupation

and education level (P<0.001)

while political status or religion were not significant. For the factors related to becoming a tissue donor

older age

male

white-collars (including white-collar

civil servant

teacher

soldier

lawyer

salesman

healthcare provider)

higher education level

party members (including the Chinese Communist Party members

democratic party members

and the Communist Youth League members) (P<0.05). Conclusions The registered tissue donors have better understanding and more positive attitude towards cornea donation than control residents do. They approve of the legislation of cornea donation and free donation protocol. It may be more effective to target the population of over 58 years old

male

white-collars

well-educated people

and party members in the promotion of cornea donation.