Eyeworld

EW NEWS & OPINION 20 May 2017 by Erin Murphy Contributing Writer tion networks, learning experiences and donor tissue can be hard to find. Nonprofit global eye bank networks see this disparity firsthand and are working to bridge the gap. The ISR established the VISIO Training Academy in 2010 through which it has provided educational programs in Georgia, Syria, Trini- dad, Russia, and Iraq as well as at its Bradenton, Florida, headquarters. Anthony J. Aldave, MD, is chief of the Cornea and Uveitis Division at UCLA's Stein Eye Institute. In 1- and 2-day programs at the ISR VISIO training academy in Florida, Dr. Al- dave lectures and conducts wet labs for doctors from around the world to learn advanced corneal transplant techniques such as Boston kerato- prothesis, deep anterior lamellar ker- atoplasty, and Descemet's stripping automated endothelial keratoplasty. "We teach two or three train- ees in a session, which allows us to customize the lecture and wet lab experience to the attendees' interests and levels of experience," Dr. Aldave said. "I have worked with surgeons from the Middle East, Mexico, and South America through the ISR VISIO Training Academy. Two years ago, I taught two surgeons from Mexico City the Boston kerato- prothesis procedure and then visited their hospital 6 months later to help them put what they had learned into action in a proctored manner to ensure optimal outcomes." Getting tissue abroad In addition to training surgeons, global eye banks ensure that they and others can access corneal tissue in their home countries. Currently, the deficit of donor tissue in many countries is dramatic, and many millions of patients cannot get the treatment they need. Julio Narváez, MD, an adjunct professor at Loma Linda University who practices at Delta Eye Medical Group in Stockton, California, takes service trips nearly every year to per- form eye surgery in such countries as Belize, Fiji, Lesotho, Rwanda, and Zambia. "There is no infrastructure for care. If a patient is blind, there is nothing anyone can do—the resources needed to regain vision the first eye bank was established in New York City, American eye banks have developed large donor pools, streamlined retrieval processes, and built broad, efficient distribution networks that put corneal tissue in surgeons' hands where and when they need it. In fact, eye banks in the U.S. do such good work that supply exceeds demand. The surplus tissue does not go to waste; instead, nonprofit eye bank networks dis- tribute tissue to patients around the world. These global eye banks serve the purpose of restoring sight to people who would otherwise have no hope of treatment. Several eye banks in the U.S. have this capability. One is the nonprofit Vision Share consor- tium of eye banks, which distributes corneal tissue for transplantation, research, and education in the U.S. and around the world. Vision Share also provides educational opportu- nities to help surgeons learn new procedures. Another global network is the nonprofit Lions Eye Institute for Transplant & Research, Inc., which recently acquired an organization called International Sight Resto- ration (ISR) to expand its global reach and educational programs. The ISR also works to raise donor awareness abroad to address urgent shortages of donor tissue. Importance of training To learn the latest techniques in corneal surgery, physicians read the literature and watch videos, but they cannot begin to perform new proce- dures such as Descemet's membrane endothelial keratoplasty or pre-De- scemet's endothelial keratoplasty without training and repetition in a wet lab using donated corneal tissue. In the U.S., these training opportu- nities occur at hospitals, universities, and eye banking facilities, using readily available banked tissue. In other countries with less es- tablished donor pools and distribu- How non-profit eye bank networks expand access to treatment and teaching around the world G lobally, corneal diseases are the second most com- mon cause of blindness, behind cataract. 1 Nearly 5 million people suffer bilateral corneal blindness, and many millions more have a unilater- al condition. 1 The majority of these patients reside in the developing world. These patients need corneal tis- sue and surgeons who know how to perform sight-restoring procedures. Today, the best hopes for many of these patients are the distribution network and educational services provided by eye banks here in the United States. Global eye banks In the more than 7 decades since Tissue for all Dr. Aldave assists surgeons in Shenyang, China, implanting corneas received through ISR's SEEson's Gift of Sight Campaign Source: Anthony J. Aldave, MD continued on page 22

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