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

Abstract

AbstractPurpose The whole eye banking (EB) process, from corneal retrieval to surgery, is improving. Paradoxically, corneal blindness worldwide is still increasing. Supply seems lagging far behind global demand but only partial data of the worldwide situation is available. We therefore launched an international survey on the balance of demand and supply, called the “Worldwide Eye Banking” (WEB)‐project. Our goal is to identify suitable solutions in countries willing to improve their corneal supplyMethods Descriptive epidemiological worldwide transversal study. A questionnaire was designed and e‐mailed to EB staff and ophthalmologists involved in corneal grafts using mailing lists from local and international ophthalmological societies or by face to face interview during international ophthalmology, eye research or EB congressesResults Significant disparities were highlighted. Developed countries tended to satisfy corneal demand. EBs in the United‐States use short term storage and are exporters, while Europeans use long‐term organoculture and nearly satisfy local demand. Keratoplasty indications have 2 profiles: infections, mainly trachoma, for developing countries and keratoconus, endothelial dystrophy or iatrogenic edema in developed countriesConclusion This demand/supply disparity, at this stage of the study (ongoing), is severe in most 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