Eye banking and corneal transplantation最新文献

Agentic Artificial Intelligence in Eye Banking: A Proposed Workflow. 人工智能在眼银行中的应用：一个建议的工作流程。

Eye banking and corneal transplantation Pub Date : 2026-06-01 Epub Date: 2026-05-27 DOI: 10.1097/ebct.0000000000000054

Ranit Karmakar, Elizabeth Kassahun Kiros, Siddharth Nath, Pearse A Keane, Krishna Kumar, John Lohmeier, Shameema Sikder, Eric Meinecke, Chris Hanna, Allen O Eghrari

{"title":"Agentic Artificial Intelligence in Eye Banking: A Proposed Workflow.","authors":"Ranit Karmakar, Elizabeth Kassahun Kiros, Siddharth Nath, Pearse A Keane, Krishna Kumar, John Lohmeier, Shameema Sikder, Eric Meinecke, Chris Hanna, Allen O Eghrari","doi":"10.1097/ebct.0000000000000054","DOIUrl":"10.1097/ebct.0000000000000054","url":null,"abstract":"Purpose: To develop an agentic artificial intelligence (AI) framework that streamlines and standardizes eye bank operations by automating donor screening, image analysis, and tissue suitability assessment under expert supervision.Methods: A modular, on-premises, multi-agent system was designed consisting of three AI agents. The Donor Screening Agent analyzes medical histories to identify contraindications for ocular donation. The Corneal Image Analysis Agent interprets multimodal images, including specular microscopy, slit-lamp, and optical coherence tomography, to quantify endothelial cell density, morphology, and clarity. The Suitability Assessment Agent integrates outputs from both preceding agents to generate structured recommendations for transplantation, research use, or rejection. Each agent operates locally to ensure privacy, real-time processing, and compliance with health information regulations.Results: The proposed architecture replaces fragmented manual workflows with a unified, intelligent system that reduces variability, accelerates evaluations, and enhances transparency. By enabling consistent and rapid analysis of donor data and corneal images, the system can improve tissue utilization and decrease discard rates. A modular, low-latency design supports deployment in diverse settings, including low- and middle-income countries, where connectivity and infrastructure may be limited.Conclusions: Agentic AI offers a scalable pathway toward a standardized eye banking process by combining automation with human oversight. This approach has the potential to improve decision quality, operational efficiency, and equity in corneal transplantation. It carries implications for both limited resource settings and the broader context of transplantation medicine.","PeriodicalId":521098,"journal":{"name":"Eye banking and corneal transplantation","volume":"5 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13409418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intraoperative Peripheral Iridotomy for Endothelial Keratoplasty with a 22-Gauge Needle. 22号针术中虹膜周围切开术治疗内皮角膜移植术。

Eye banking and corneal transplantation Pub Date : 2026-03-01 Epub Date: 2026-03-30 DOI: 10.1097/ebct.0000000000000052

Zainab Rustam, Anshuman Agrawal, Rhea Kulkarni, Fahd Mohamed, Jonathan Thomas, Joanne Choi, Christine Wang, Derick O Ansah, Phoenix Fan, Paloma R Mitra, Krystal Yearis, Fasika A Woreta, Divya Srikumaran, Allen O Eghrari

{"title":"Intraoperative Peripheral Iridotomy for Endothelial Keratoplasty with a 22-Gauge Needle.","authors":"Zainab Rustam, Anshuman Agrawal, Rhea Kulkarni, Fahd Mohamed, Jonathan Thomas, Joanne Choi, Christine Wang, Derick O Ansah, Phoenix Fan, Paloma R Mitra, Krystal Yearis, Fasika A Woreta, Divya Srikumaran, Allen O Eghrari","doi":"10.1097/ebct.0000000000000052","DOIUrl":"10.1097/ebct.0000000000000052","url":null,"abstract":"Purpose: To describe the approach and advantages of a 22-gauge (22G) needle for intraoperative peripheral iridotomy (PI) during endothelial keratoplasty.Methods: A superior approach is utilized to make an inferior PI. Intracameral lidocaine 1% and acetylcholine chloride 1% are injected intracamerally via a superior 1.1mm paracentesis incision for pain control and miosis. The 22G needle is bent near the hub with the bevel facing down. It is inserted through the paracentesis and passes through the pupil. As the needle-tip advances under the inferior iris, it is lifted periodically to identify its position until it reaches the ideal point for the PI. Counter-pressure is applied to the limbus at the exit point. The needle-tip is angled up and pushed through the iris and limbus so that the needle-shaft creates a standardized, patent, circular iridotomy (approximately 0.7mm diameter and 0.4mm2 area). We compared the time needed for PI creation using intraocular scissors versus a 22G needle by evaluating 10 surgical videos for each technique and statistically analyzing the timings using the Mann-Whitney U test and Bootstrapping.Results: The median time to produce a PI using a 22G needle was 19 seconds (IQR: 14 to 24), compared to 85.5 seconds (IQR: 57 to 258) when using intraocular scissors (p<0.001, difference: 66.5 seconds, 95% CI: 33.5 to 238 seconds).Conclusion: A 22G needle offers a safe, affordable, and efficient method using a standardized size diameter to produce an inferior PI during endothelial keratoplasty. Additional studies would assist to identify an ideal needle size across global populations.","PeriodicalId":521098,"journal":{"name":"Eye banking and corneal transplantation","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13038294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Meeting the Need for Corneal Transplantation in Syria: Islamic Perspectives and Barriers to Building a Sustainable Eye Banking System. 满足叙利亚角膜移植的需求：伊斯兰观点和建立可持续眼库系统的障碍。

Eye banking and corneal transplantation Pub Date : 2025-12-01 DOI: 10.1097/ebct.0000000000000045

Mohamad Tarek Madani, Basel Tarab, Buraa Kubaisi, Ahmad Kunbaz, Nuha Alfayumi, Hajirah N Saeed, Ahmad Al-Moujahed

{"title":"Meeting the Need for Corneal Transplantation in Syria: Islamic Perspectives and Barriers to Building a Sustainable Eye Banking System.","authors":"Mohamad Tarek Madani, Basel Tarab, Buraa Kubaisi, Ahmad Kunbaz, Nuha Alfayumi, Hajirah N Saeed, Ahmad Al-Moujahed","doi":"10.1097/ebct.0000000000000045","DOIUrl":"10.1097/ebct.0000000000000045","url":null,"abstract":"Purpose: The aim of this study was to explore the religious, cultural, and systemic barriers to corneal donation and transplantation in Syria and to propose a context-specific framework for establishing a sustainable eye banking system.Methods: We conducted a narrative review incorporating retrospective data from Syria's largest eye hospital and an analysis of Islamic legal opinions related to corneal donation. Key barriers to donation and access to corneal transplantation were identified through thematic synthesis of clinical and religious sources.Results: Between 1997 and 2025, over 74% of documented cases of corneal pathology requiring transplantation remained untreated because of limited infrastructure, severe shortages in donor tissue, and cultural beliefs. While public hesitancy is driven by concerns over bodily integrity and mistrust in the health system, Islamic jurisprudence overwhelmingly supports corneal donation as a permissible and charitable act.Conclusions: Religious alignment and community education present major opportunities for expanding corneal donation in Syria. We propose a framework for sustainable eye banking rooted in operational feasibility, religious endorsement, and public trust.","PeriodicalId":521098,"journal":{"name":"Eye banking and corneal transplantation","volume":"4 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Feasibility of Descemet membrane endothelial keratoplasty with preloaded and trifolded graft after 96-hour storage and shipping. 96小时储运后预载三叠式角膜移植术的可行性。

Eye banking and corneal transplantation Pub Date : 2025-06-01 Epub Date: 2025-04-17 DOI: 10.1097/ebct.0000000000000036

Tara Srinivas, Christine Wang, Allen O Eghrari

{"title":"Feasibility of Descemet membrane endothelial keratoplasty with preloaded and trifolded graft after 96-hour storage and shipping.","authors":"Tara Srinivas, Christine Wang, Allen O Eghrari","doi":"10.1097/ebct.0000000000000036","DOIUrl":"10.1097/ebct.0000000000000036","url":null,"abstract":"Purpose: Descemet membrane endothelial keratoplasty (DMEK) donor grafts can be safely trifolded, preloaded, and shipped for up to 96 hours without significant endothelial cell loss; however, clinical outcomes of such storage times have yet to be reported in human patients. Here we report a case of a trifolded, preloaded DMEK graft stored for 96 hours and transplanted in a 68-year-old female with Fuchs endothelial dystrophy.Methods: The DMEK graft was preloaded and trifolded with post-processing endothelial cell density (ECD) of 2558 cells/mm.2 Intraoperatively, it was pulled into the anterior chamber with 27G irrigating forceps, opened as a sheet, and was positioned without complication using SF6 gas with 80% fill. The graft was attached at all postoperative day visits including day 1, 5, and week 6. Specular microscopy at one week resulted in ECD of 1930 cells/mm2 (endothelial cell loss of 22.8%), and central pachymetry improved from 530 microns preoperatively to 493 at six weeks.Conclusions: We demonstrate feasibility of DMEK with a preloaded and triolded graft stored for 96 hours, with resolution of corneal edema. These results underscore the viability of international shipment and optimized resource distribution of donor tissue where there is a high global need for DMEK grafts.","PeriodicalId":521098,"journal":{"name":"Eye banking and corneal transplantation","volume":"4 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12571236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145411295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Descemet Membrane Endothelial Keratoplasty in an eye with 33mm axial length. 眼轴长33mm的视网膜内皮角膜移植术。

Eye banking and corneal transplantation Pub Date : 2025-06-01 Epub Date: 2025-06-30 DOI: 10.1097/ebct.0000000000000041

Anshuman Agrawal, Joanne C Choi, Olivia Dryjski, Derick O Ansah, Christine Wang, Allen O Eghrari

{"title":"Descemet Membrane Endothelial Keratoplasty in an eye with 33mm axial length.","authors":"Anshuman Agrawal, Joanne C Choi, Olivia Dryjski, Derick O Ansah, Christine Wang, Allen O Eghrari","doi":"10.1097/ebct.0000000000000041","DOIUrl":"10.1097/ebct.0000000000000041","url":null,"abstract":"Purpose: To describe the preoperative planning, intraoperative surgical techniques, and postoperative outcomes of Descemet Membrane Endothelial Keratoplasty (DMEK) in an eye with extreme axial myopia.Methods: A 71-year-old female patient with severe 4+ nuclear sclerotic cataract and Fuchs dystrophy in the right eye presented with best corrected visual acuity of counting fingers. Central corneal thickness (CCT) was 605 microns, and optical biometry-based axial length was 33mm. The DMEK graft was preloaded as a 7.5mm diameter scroll in a micro Jones tube, injected into the anterior chamber (AC), and opened without complication.Results: Intraoperatively, the AC deepened and shallowed extensively, consistent with zonular laxity. Despite a large volume of SF6, exotropia resulted in nasal displacement of the bubble and delayed attachment of the inferotemporal graft. Two subsequent 200μL air bubbles were placed in clinic with the inferotemporal graft attaching after the patient laterally positioned on her non-operative side. After 1 month, visual acuity improved to 20/500, limited by myopic degeneration, and CCT to 525 microns. By six weeks, the graft was fully attached and the cornea clear.Conclusions: DMEK is feasible in eyes with extreme axial length, but presents distinct challenges such as zonular laxity and exotropia. This case underscores the importance of individualized surgical planning and positioning in achieving successful outcomes in highly myopic eyes.","PeriodicalId":521098,"journal":{"name":"Eye banking and corneal transplantation","volume":"4 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0