The Development and Status of Eye Banking with Special Focus on the Commitment of LIONS Clubs. / Entwicklung und Stand des Hornhautbankings unter besonderer Berücksichtigung des Engagements von 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.

[Calculating the Human Eye - The Evolution of Biometry for Cataract Surgery]. / Die Berechnung des menschlichen Auges ­ zur Evolution der Biometrie in der Kataraktchirurgie.

INTRODUCTION: Optical biometry is the standard diagnostic tool and essential basis for IOL calculation prior to cataract surgery today. Our article will provide a short overview of the historical development of biometry of the human eye and the formulas used for IOL calculation. MATERIAL AND METHODS: Selective literature search in books and journal articles via PubMed, Google Scholar and Google as well as close cooperation with IOLCon at Saarland University, Homburg/Saar (Germany). RESULTS: For first measurements of the eye, ultrasound was applied invasively. Today, ultrasound is mostly restricted to cases where optical biometry cannot be performed due to opaque optical media. However, today, most of the modern biometers are working with OCT non-invasively. Along with this technical evolution, numerous formulas have been developed for calculating the optical power of each respective IOL. Intraocular lenses can be calculated with different strategies: with empirical formulas, the IOL power is derived from a series of biometric data without any anatomical or physical background. With the theoretical-optical formulas, which are most commonly used today, the IOL power is extracted from a paraxial optical model which simplifies the eye to linear Gaussian optics. With modern raytracing settings, the Snell's law is applied at each refracting surface within the eye and the best focus position is compared with the position of the fovea. CONCLUSIONS: Today, an increasing number of eyes that underwent refractive surgery previously are facing cataract surgery. Maybe even more important than adequate biometry of the human eye will be using appropriate calculation schemes in order to enhance post-cataract refractive outcomes or predictability.