Opportunities and Challenges in Global Eye Banking: A Review.

Abstract

Objective: This article aims to review the current literature on the severity of global corneal blindness (CB), summarize the current challenges of corneal eye banks in low and middle-income countries (LMICs), and highlight key principles and opportunities for improvement in corneal eye banking in these countries.

Methods: In this article, we reviewed available literature pertinent to global CB and corneal transplantation (CT), and eye banking in LMICs, in addition to supplementation with personal communication with eye banking staff working in LMICs.

Results: CB is a major cause of global blindness and visual impairment, with numerous etiologies varying by geography, socioeconomics, and age. CT remains the mainstay in surgical intervention for CB, with a robust corneal eye banking system playing a critical role in efforts to decrease the amount of CB. Four vital functions of eye banks include consent, recovery, processing, and distribution, with challenges and opportunities present within each. Eye bank infrastructure in LMICs has had numerous successes and setbacks in the last 20 and much work remains to be done.

Conclusions: Much remains to be done in the aim to treat global CB, however, the establishment of ethical, efficient, and high-quality corneal eye banks with subsequent CT acts as a key pillar in the multifaceted approach. With the ultimate goal of self-sufficiency, many eye banks in LMICs lead by example in surmounting challenges shared internationally, and set the stage for others to seize the opportunity to provide tissue to cure CB.