Worldwide Eye Banking (WEB) project: International survey of demand and supply

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Abstract

Purpose

The whole eye banking (EB) process, from corneal retrieval to surgery, is improving. Paradoxically, corneal blindness worldwide is still increasing. The corneal supply is lagging far behind global demand. Few and partial works exist in this field. This has motivated our international survey: the Worldwide Eye Banking (WEB) project. Our final goal is to identify suitable solutions for countries willing to improve their corneal supply

Methods

Design: A descriptive epidemiological worldwide transversal study. A questionnaire consisting of 23 items on keratoplasty and EB was designed. The data was collected from EB staff and corneal specialists via e-mailing, phone calls or direct interviews during international ophthalmology, eye research or EB congresses

Results

Data was collected from more than 100 countries; covering a world population of 6.5 billions. Approximately 125 000 keratoplasties are performed each year from the 175 000 corneas collected. US EBs, first corneal exporter, use short-term storage while Europeans use long term organoculture. Lamellar keratoplasty is a new trend. Surgical indications have 2 profiles: infections for undeveloped countries; keratoconus and bullous keratopathy in industrial countries

Conclusion

This demand/supply disparity is huge in many developing countries. Decreasing demand requires: 1) Trachoma fight in endemic zones 2) Iatrogenic edema prevention. Increasing supply requires: 1) Corneal donation politic dynamism 2) Local eye banking implantation in each country 3) Optimizing storage technique for better efficiency (retrieved/delivered graft ratio) 4) Bioengineering of endothelial graft. No financial interest for all authors

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