Eyeworld

EW MEETING REPORTER January 2011 59 T he 2010 Asia Cornea Soci- ety (ACS) meeting began December 1 with a mean- ingful opening ceremony. Ichigo ichie, the Japanese say. Literally, this means "One time, one meeting." In English, the phrase means something like "once in a lifetime"; a chance encounter, a mir- acle that brings people together for something important, grand, or oth- erwise life-altering. This was the sen- timent with which the Japanese organizers welcomed delegates to the 2nd Asia Cornea Society (ACS) Biennial Scientific Meeting, cur- rently being held in Kyoto, Japan. The meeting, Shigeru Ki- noshita, M.D., Ph.D., said at the meeting's opening ceremony, comes at a time when cutting edge ad- vances are being made in the field of cornea surgery; exciting things, he said, are happening all over the world in transitional and clinical re- search, all of which will be presented at the meeting. Hence the meeting's theme: An Enlightening Focus on the Future. Dr. Kinoshita is the Presi- dent and Organizing Committee Chairman of the meeting. Donald Tan, M.D., President of the ACS, shared his enthusiasm and optimism. "We hope this marks the start of a truly international effort," he said. "We really hope to make a difference." At the opening ceremony, Dr. Kinoshita had the honor of deliver- ing the 2010 Asia Cornea Founda- tion lecture, "Therapeutic modalities for corneal disease." In his lecture, he described four therapeutic modal- ities that have come into being in the last few years, thanks to the progress made in understanding the pathogenesis of corneal diseases: Bi- ological modalities, including the various techniques for cultured cornea epithelial stem cell transplan- tation; immunological modalities, including immunosuppressive ther- apy for conditions like Mooren's corneal ulcer; microbiological ap- proaches, such as the use of antimi- crobials in meibomitis; and a combined and integrated approach involving elements of the previous three modalities, particularly for cases such as Stevens–Johnson Syn- drome. One exciting development in the foreseeable future is the use of Rho-associated kinase (ROCK) in- hibitor in the treatment of endothe- lial cell dysfunction. ROCK inhibitor diminishes disassociation-induced apoptosis of endothelial cells. Also honored during the open- ing ceremony: Jules L. Baum, M.D., who delivered the ACS Special Recognition Lecture "Chase, Chance, and Creativity," borrowing the title of a book written by James Austin, M.D. (MIT Press, 2003), using it to succinctly sum up the joys of research; and Teruo Nishida, M.D., who delivered his ACS Special Recognition Lecture "Conversation between epithelial cells and fibrob- lasts." In his lecture, Dr. Nishida de- scribed research he and his colleagues conducted on the rela- tionship between epithelial cells and fibroblasts. The meeting ran from December 1 to 3, 2010, and was held at the Westin Miyako Kyoto, in collabora- tion with the Cornea Society, the ASCRS, and the Japan Cornea Soci- ety. Eye banks of the world unite Eye banking is "critical" to ocular surface disease management, said Paul Dubord, M.D., Canada. In broad strokes, Dr. Dubord painted the global picture: About 314 mil- lion people around the world are vi- sually impaired—152 million (49%) due to refractive errors, 161 million (51%) due to various ocular condi- tions that include diseases and trauma; about 1 million corneal transplants need to be performed globally every year, but only about 30,000 are currently being per- formed a year. Moreover, 90% of all people who are blind due to condi- tions affecting the cornea can be found in developing countries, while most eye banks are "in the wrong spot"—for instance, many eye banks can be found in the United States and in developed Eu- ropean countries, while most pa- tients who need corneal transplants are in Africa and Asia. Dr. Dubord identified two gen- eral challenges to eye banking any- where in the world: shortage of tissue, and a lack of healthcare infra- structure. Ultimately, he said, the goal of eye banking should be to supply tissue for corneal transplanta- tion to all patients at all levels of so- ciety, anywhere in the world. In Asia, as elsewhere, the obvious prob- lem is lack of donors, said Donald Tan, M.D., Singapore; this is particu- larly challenging in the region due to various religious, cultural, and so- cial impediments. Adopting Western strategies, he said, might not work too well. Dr. Tan described six categories of eye bank that can be found in Asia: (1) small, insular "eye banks" that are little more than a refrigera- tor or two used for temporary tissue storage serving individual institu- tions; (2) medium-sized eye banks that collectively may serve more than one institution in individual communities; (3) larger eye banks that are reasonably successful but are not yet able to procure an ade- quate supply of tissue for the re- gional/national needs they are designed to meet; (4) large eye banks that are encumbered with long wait- ing lists; (5) large eye banks that are able to procure an adequate supply of corneas for their own needs, but not enough to export tissue; (6) the as-yet nonexistent gold standard: a large, self-sufficient eye bank, with a supply sufficient for both national/regional needs and export. There are many category 1 eye banks, but these are in fact more detrimental than helpful, adding to the already numerous challenges eye banks face in Asia, said Dr. Tan. The Association of Eye Banks in Asia (AEBA), established in January 2009 with the aim of being a truly supra- national, non-profit, professional or- ganization to develop current eye banks and establish new ones where necessary, hopes to meet these chal- lenges, he said. One strategy recommended by AEBA is the institution of hospital eye development programs (HEDP), in which eye centers tap other, non- ophthalmologic institutions for eye donations. However, in order for eye banks to be successful on a national level, governments need to get in- continued on page 60 Editors' note: This Meeting Reporter contains original reporting by the EyeWorld News Team from the 2010 ACS Meeting, Kyoto. Reporting live from the 2010 Asia Cornea Society meeting, Kyoto, Japan by Chiles Samaniego EyeWorld Staff Writer

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