The Development and Status of Eye Banking with Special Focus on the Commitment of LIONS Clubs.

Background: Ever since the first successful keratoplasty in 1905, there has been a need to store corneas for transplantation. R. Townley Paton founded the first eye bank in New York in 1944. With Helen Keller's call in 1925 for LIONS to "constitute themselves Knights of the Blind in the crusade against darkness", LIONS Clubs International has become involved in the establishment of eye banks worldwide. This paper presents the development of eye banking in general and with special attention to the support offered by LIONS Clubs.

Methods: Selective literature search through PubMed, Google Scholar and Google in close cooperation with the LIONS Eye Banks already established in Germany, LIONS Clubs International (USA) and the Julius Hirschberg Society (Austria). Analysis focused on the founding processes of 6 German eye banks and their current services.

Results: Filatov was the first to keep donor eyes in a cool, moist container for a few days. In 1973, Summerlin et al described the technique of organ culture for donor corneas, and McCarey & Kaufman described a liquid storage medium in 1974. LIONS Clubs International and their organisational structure first supported an eye bank in the US in 1952, outside America in Hong Kong in 1962 and in Germany in 1969. Funding is provided across all levels of LIONS as network support and material resources. In general, staff funding is not provided. Of the 88 eye banks operating worldwide today, 44 are called LIONS Eye Banks. 6 of the current 26 eye banks in Germany are operating under LIONS sponsorship and run by departments of ophthalmology at university medical centres. Although the number of transplants has increased in recent years due to new surgical techniques, the number of patients waiting for donor tissue is also growing as a result of the broadening indication.

Conclusions: Even today, the availability of donor corneas limits patient care. Eye banks help to meet the need for donor corneas. However, the techniques and technical equipment of eye banks must undergo continuous improvement. The local, national and international network of LIONS Clubs can assist in establishing these in order to facilitate legal requirements and structural developments. This support frequently lasts for many years, often triggers additional public commitment and is thus also a supporting element for the future development of eye banking in Germany.