RESTORING SIGHT WORLDWIDE 2013 EBAA YEAR IN REVIEW
CHAIR’S
ADDRESS: As I look back on this past year one word comes to mind, “transition.” EBAA has successfully transitioned in a number of ways, is transitioning in many others, and looks forward to yet more change in the coming years. This past year we marked the first full year for our new President and CEO, Kevin Corcoran. Kevin began his tenure by visiting a number of eye banks and has continued to make himself available to the membership by contacting eye banks and visiting them as he travels. He has immersed himself in the transplant community and has created relationships that will serve EBAA into the future. He knows the pressures of eye banking and appreciates the
2
hard work and dedication it takes to accept the mantle “eye banker.” Kevin has shown himself to be an eye banker, through and through. We continue to see transition in the leadership of our Association. I am very pleased to see younger eye bankers active on committees and serving in leadership roles. I am also happy to see the success of the Young Physicians Leadership Program, started by Immediate Past Chair Dr. Marian Macsai, resulting in almost 20 young physicians serving on EBAA boards and committees. Also, this past year we awarded the Certified Eye Bank Technician title to 50 technicians! I encourage all of you, eye bankers and physicians,
to begin thinking about what your place in EBAA can be. From our strategic plan we see transition happening as well. At our last annual meeting, we voted on a way to make the EBAA Medical Standards accessible to those in the international community who want to use it. We have two adhoc committees examining the structure of our association — from task forces, committees, and boards, to member representation on our Board of Directors. Also, we have embarked on an international outreach program; so far, it has resulted in two new international members of EBAA (one in Hong Kong, and the other
As I look back on this past year one word comes to mind, “transition.”
in Daqing, China), both of which have expressed interest in being accredited by EBAA. Also, EBAA is participating closely with the Global Alliance of Eye Bank Associations. One of the other issues to come from the strategic plan is the completion of an updated study on eye bank finances and the costs associated with turning the precious Gift of Sight into a viable cornea transplant. Our last comprehensive study was done under threat of cornea fee capitation in 1999, the current study (aka “The Lewin Study”) will be performed under less critical conditions and should be completed in a few months.
As we move into our next year, we see many changes happening on the technical and administrative sides of eye banking.
As we move into our next year, we see many changes happening on the technical and administrative sides of eye banking. The advent of new procedures and longerterm outcome data of these procedures are going to drive the way we accomplish our mission. The challenges of being an eye bank administrator are increasing as “tissue reimbursement” becomes an increasingly used phrase. I am confident that, as we always have, eye bankers will rise to these changes and meet them with commitment to mission, as good stewards of the Gift, and as leaders by example in the transplant community.
Lastly, I want to say how proud I am of everyone who serves eye banking. From the EBAA staff in Washington, D.C., to the various committees, boards, and many ad-hoc groups commissioned by me and Committee Chairs. But also, I want to thank the staff at our member eye banks that may not have the opportunity to serve EBAA directly. Your dedication shows and our profession is what it is because of you. Thank you. Very Sincerely,
Dave Korroch, CEBT EBAA Chair 2012–2014
2013 EBAA YEAR IN REVIEW
PRESIDENT’S
ADDRESS: Dear EBAA Members: The start of the year is traditionally an opportunity to reflect on the year gone by — to assess our successes and learn from our shortcomings. It’s an opportunity to take stock of where we have been and where we’re going. Usually, this happens on January 1, but since EBAA’s fiscal year starts on July 1, this is when we prepare the Year in Review. This is our report to you, as the association’s members and owners, on how we have used the financial, operational and intellectual resources you have made available to us.
4
This past year was one in which we increased our capacity to serve our members. Having conducted our first comprehensive member survey in years, we had a better understanding of your wants and needs. We then integrated those insights into a strategic plan that outlined an overarching strategy and specific action items to move the association and the profession forward. Since the strategic plan’s formal adoption by the Board in November, staff and volunteer committees have delivered on almost all of its deadlines and deliverables, and have been able to use it to guide our thinking in areas that the plan did not anticipate.
In addition to developing new initiatives, such as our legislative advocacy efforts, we have also striven to enhance the depth, breadth and value of products and services that have been EBAA mainstays for years. For example, the EBAA Statistical Report has grown from 16 pages in 2011 to 112 pages in 2013, and has added the ability to benchmark your eye bank’s performance against profession standards. Our National Eye Donor Month commemoration now includes countless resources, supplied by EBAA and your fellow eye bankers, which you can use in your own community. Also, the 2013 EBAA Annual Meeting featured
“EBAA is your association, and we want every member to feel an ownership stake in its progress and development.”
more outside speakers, more social and networking events, and more opportunities to earn Continuing Education credits than ever before. Perhaps more importantly, EBAA has added, and will continue to add, more ways for members to engage in the association’s functions and governance. Dave Korroch has made strides to diversify EBAA’s committee participation, seeking out new voices and perspectives to add to our conversations. Where appropriate, we’ve created small Advisory Groups to assist with specific projects or initiatives; these groups may form, perform their task and disband in the matter of
a few weeks or months. We have also distributed surveys to gather the viewpoints of the membership as a whole. In retrospect, perhaps we used this last method a bit too frequently, as a number of members have expressed “survey fatigue.” We will continue to seek your opinion, but will be more selective in our methods.
EBAA has added, and will continue to add, more ways for members to engage in the association’s functions and governance.
you to read and respond to this report, to tell us how we can serve you better. Sincerely,
Kevin P. Corcoran CAE President and CEO
We’ve done all this in an effort to support your eye bank and strengthen your profession. EBAA is your association, and we want every member to feel an ownership stake in its progress and development. EBAA’s success is defined by its members’ success, so I encourage 2013 EBAA YEAR IN REVIEW
RECIPIENT STORY: THELMA CARDWELL-CALE Water color created by Ms. Cardwell-Cale
Additional artwork by Ms. Cardwell-Cale may be viewed here.
6
“Sight is a miracle!”
“You have Fuchs’s Dystrophy,” the doctor said. “Come back when you’re blind.” I couldn’t believe my ears. I was in shock as I left the doctor’s office. I immediately rushed to my husband for his comfort. Together we looked up this Fuchs’ Dystrophy and learned that is usually found in women over the age of 50. I was around my 30s. I thought “I’m too young to go blind.” Besides, I’m an artist, a wife, and a mother of 3 children and several foster children. I thought my doctor must have misdiagnosed me. At the time of my diagnosis, I lived in Pleasanton, TX. Every time I heard of a “good” ophthalmologist that might know something new about this disease, I traveled to his/her office. I didn’t care if I had to drive 40 minutes to San Antonio, an hour to Austin or 3 hours to Corpus Christi. I soon learned that it didn’t matter how far I traveled, because the diagnosis was always the same. I waited throughout the years and my eyesight steadily declined. It was not until much later that I learned
about corneal transplantation and that the donated cornea would come from a deceased person. I went home and prayed. I felt very sad; I didn’t want someone to die so I could see. I was fortunate to meet Dr. Snip, who was the Medical Director for the San Antonio Eye Bank. After my exam, he told me I would be an excellent candidate for a transplant and said, “When a family donates their loved one’s corneas, they do so because they want to help someone in need.” I was told very little information about my donor. I learned that my donor was male and around the age of 60. At the time of the surgery, I was 67 years old. I received the transplant in my right eye, and 14 years later, I am still immensely grateful for the man and his family that made the decision to donate. In 2011, when I was 79, I received a transplant in my left eye, thanks to Dr. Maverick. New advancements in transplantation allowed for fewer stitches and a faster healing time.
I don’t know any details about my second donor, but I am as grateful for my second transplant as I am my first. I have never wasted the Gift of Sight bestowed upon me and through my artwork I honor both my donors’ legacies. In 2010, one of my fine art paintings was printed on close to 100,000 H-E-B grocery shopping totes. Moreover, 15,000 of my coloring books have been issued for school children. I have volunteered for 17 years teaching art at an alternative school for students age 8 to 17, and I also volunteer teaching adult art classes. Thanks to the generosity of strangers — my cornea donors — Dr. Snip and Dr. Maverick, my restored vision has enabled me to continue to give back. Words cannot express how thankful I am to my donors and future donors who help patients in need. Sight is a Miracle!
2013 EBAA YEAR IN REVIEW
VISION FOR CONTINUED SUCCESS EBAA Strategic Plan
In November 2012, the Board of Directors approved a new strategic plan, titled Vision: EBAA, which will shape the association’s direction and efforts through 2015. The plan was structured along five broad initiatives;
1
2
3
4
5
ADVOCACY
BRAND/VALUE
INTERNATIONAL
GOVERNANCE
THE FUTURE
8
Each of these initiatives has a number of specific goals and action items that, taken together, will help us fulfill EBAA’s mission. Each has been scheduled for completion within a specific time of year, thus helping to keep the association on track. We are substantially on schedule with the completion of these action items through the second quarter of 2013. In some areas, we’re significantly ahead of schedule, such as meetings with legislators and their staffs; we’ve made 52 visits when only six were anticipated. In other areas, experience or other priorities have forced us to postpone or re-evaluate action items or initiatives. For example, we quickly realized that we would be unable to host a Leadership Conference just four months after the plan had been approved, so postponed that event to early 2014, which affected a number of other action items. But we remain committed to completing all of the initiatives included in the plan. We have developed a dashboard that allows both the staff and the Board of Directors to track our progress on every aspect of the strategic plan; members can study the dashboard by clicking here, and can find the full text of the strategic plan here. Already, Vision: EBAA has helped us realize a number of successes, including:
Enhanced legislative advocacy program, including nearly 100% coverage of the four key legislative committees in the Senate and the House of Representatives. (See the Legislative Advocacy section elsewhere in this report for more details).
I nitiation of cost–benefit analysis of eye banking and corneal transplantation, examining the process from first donor contact to follow-up with the recipient.
Closer affiliation with aligned organizations such as AATB, AAO, AOPO, ASCRS, Donate Life America, and others.
International outreach, including a plan to disseminate EBAA’s Medical Standards to eye bank associations around the world.
Members are encouraged to monitor our progress and provide feedback and insights that will help us complete our goals.
2013 EBAA YEAR IN REVIEW
EBAA: YOUR ASSOCIATION AT WORK Legislative Advocacy Educating Congress about Eye Banking For the first time in its history, EBAA initiated a comprehensive, sustained campaign to educate legislators about how eye banking and corneal transplantation benefit their constituents and the country as a whole. The association has done so because the typical eye bank relies on tissue reimbursement fees for up to 90% of its total revenue, and 100% of that fee is directly or indirectly dependent on corneal tissue maintaining its pass-through status under the Centers for Medicare and Medicaid Services (CMS). While no one in CMS or on Capitol Hill has suggested that corneas’ status should change, budgetary shortfalls are forcing Congress to make
10
difficult decisions, and without an assertive education effort by EBAA, they could make an uninformed decision with unintended consequences for sight restoration. Two committees in the House (Ways & Means and Energy & Commerce) and two in the Senate (Finance and Health, Education, Labor and Pensions) hold the most immediate sway over eye banking’s future, and each has a healthcare subcommittee. Over the past six months, EBAA has met with over 80% of the members of these committees, and we expect to have spoken with all of them by the end of September. A link to view the legislative visits can be seen here.
EBAA’s message is simple; this is who we are, this is what we do and this is how we serve your constituents. We don’t ask for anything — no requests for more money or a vote on a piece of legislation under consideration — we just inform them about eye banking. We close our meeting by explaining that cuts in reimbursement rates (which no one is seeking but which could happen in a poorly written omnibus bill) would undermine the system that facilitated over 70,000 sightrestoring transplants last year, so if we ever have to ask for their help, it will probably be about this issue. This approach has never failed to elicit appreciation for our mission and support for our continued funding. Our outreach program has already
paid dividends to EBAA members, as it has established relationships that we’ve benefitted from in other ways. In May, member eye banks began seeing 2% reductions in some of their Medicare reimbursements. They were told that this was a result of the 2% across-the-board cuts mandated by the sequestration that took effect on May 1. Since this seemed to conflict with the essence of the pass-through, we spoke with our Hill contacts. Bruce Edgren, the Health Policy Fellow in Senator Rockefeller’s office (D-WV), researched the issue and informed us that the cuts were applicable under the sequestration, but only if the physician’s contract with the Medicare Advantage
plan specifically permitted it. We communicated this information to our members, which gave them a tool to look more closely into those cuts and perhaps recoup the lost revenue. Our ultimate goal is to meet with every member of Congress. But with 538 of them, that can only be accomplished with the help of our members. That’s why we developed a Grassroots Advocacy program, which encourages every eye bank Executive Director to contact the two senators and one representative who serve his/her eye bank’s district. If every eye bank achieves this goal, we will reach three-quarters of the Senate and nearly a quarter of the House.
To support our members in this effort, we have prepared a number of resources to facilitate visits with their legislators, ranging from templates for requesting an appointment to talking points to use during the meeting, and educational materials to leave-behind after the visit. These are all available under the Legislative Advocacy tab on members-only section of the website.
2013 EBAA YEAR IN REVIEW
Regulatory Advocacy CMS Maintains Medicare Pass-Through for 2013 and 2014 The Centers for Medicare and Medicaid Services (CMS) formally ruled that Medicare will continue to pay for corneal tissue acquisition at reasonable cost. This is in part because the input costs for future years are highly unpredictable; if the prospective payment rate were set too low, hospitals may elect not to provide the service and the general public could be denied the benefit of corneal transplantation. Under the revised ambulatory surgery center payment system, corneal tissue acquisition is paid based on the invoiced costs for acquiring the corneal tissue for transplantation. EBAA Debuts The Focal Point: EBAA’s Advocacy and Regulatory Newsletter EBAA introduced a new bi-weekly electronic newsletter entitled, The Focal Point: Advocacy and Regulatory Updates, in September 2012. This e-blast is designed to report on legislative and regulatory developments to all staff members of EBAA member banks and EBAA Paton Society members. A new monthly section, called The Reimbursement Corner, was added in July 2013. To view The Focal Point archives, please click here.
12
EBAA Represented on Restructured HHS Advisory Committee on Blood and Tissue Safety and Availability Dr. Marian Macsai was appointed to represent EBAA on the Department of Health and Human Services’ committee formerly known as the Advisory Committee on Blood Safety and Availability (ACBSA). The title has been changed to the Advisory Committee on Blood and Tissue Safety and Availability (ACBTSA). For solid organs and blood stem cells, the committee’s scope will be limited to policy issues related to donor-derived infectious disease complications and transplantation. The scope has been expanded to include tissues because the ACBTSA is responsible for providing advice and making recommendations on transplantation. The committee has grown to include nine members to represent EBAA, American Association of Tissue Banks and an organ procurement organization. ACBTSA provides advice to the Secretary and the Assistant Secretary for Health.
EBAA Advises HHS on Emergency Preparedness of U.S. Tissue Supply The U.S. Department of Health and Human Services (HHS) Advisory Committee on Blood and Tissue Safety and Availability (ACBTSA) met in December to discuss the blood/organ/tissue transplant system’s preparedness in the event of a natural or man-made disaster. EBAA was invited to address the committee on eye banking’s unique characteristics. EBAA was represented by Patricia Dahl, past EBAA Chair and Executive Director/CEO of The EyeBank for Sight Restoration (EBSR). Ms. Dahl shared EBSR’s experience in two physical disasters; the terrorist attacks of September 11, and the devastation caused by Superstorm Sandy, which flooded lower Manhattan where EBSR is located, and resulted in the eye bank being blacked out for over two weeks. She was beneficial in relating the professional and personal impacts of disruptions to eye bank operations, drawing on the experience of EBSR’s staff, surgeons, and prospective donors and recipients.
...the spirit of cooperation among EBAA members will help ensure that needed tissue can be rushed to where patients might need it.
Ms. Dahl also emphasized that while eye banks, unlike tissue banks, cannot stockpile product for deployment after an emergency, the spirit of cooperation among EBAA members will help ensure that needed tissue can be rushed to where patients might need it. She illustrated this fact by making note of the 14 eye banks that helped EBSR continue to provide services to the community while its offices were without electricity, and phone or Internet service for over two weeks.
HHS, FDA, CDC, HRSA, NIH, AATB, EBAA, AOPO, UNOS, ASTS, and RTI International, which has been contracted for this study. The TODES working group was interested in EBAA’s data on communicable disease testing and other medical/social reasons tissue was determined ineligible for transplantation. They were impressed with EBAA Connect, and that in addition to collecting data from member eye banks, EBAA was able to provide an analytical tool.
Jennifer DeMatteo Appointed to Serve on HHS Tissue and Organ Donor Epidemiology Study (TODES) Working Group
The purpose of the study is to better understand the cause of rule-outs, and to seek ways to expand the donor pool. The group was surprised by the number of donors excluded because of positive HBcAb testing. This is a great opportunity to educate regulators and initiate real policy change. EBAA’s ability to position itself as a credible source of information, and to perhaps shape HHS policy on issues of importance to eye banks, demonstrates the importance of accurate and complete data in the EBAA Connect database, which will make a difference for the entire profession.
Jennifer DeMatteo, EBAA Director of Regulations and Standards, was appointed to represent EBAA on the Department of Health and Human Services’ (HHS) Tissue and Organ Donor Epidemiology Study (TODES) Working Group. This is a study funded by the Office of the Assistant Secretary of Health to look at infectious disease testing and the consequences of government regulations on organ/tissue supply, and is analogous to the retrovirus epidemiology donor study (REDS) for blood. Participants included
DOJ Working Group Releases Best Practices for Working with Medical Examiner and Coroner Offices The Department Of Justice Scientific Working Group on Medicolegal Death Investigation (SWGMDI) released the final Standards for Interactions Between Medical Examiner/Coroner Offices and Organ and Tissue Procurement Organizations and Eye Banks document. EBAA, the American Association of Tissue Banks and the Association of Organ Procurement Organizations, had submitted comments to two previous draft standards, and the SWGMDI was open to the organizations’ suggestions and recommended language. As a result of the collaborative work on SWGMDI, EBAA, AOPO and AATB are now preparing a presentation about how eye, organ and tissue banks can work cooperatively with coroners, medical examiners and other investigative entities. This presentation will be made during the National Association of Medical Examiners’ Annual Meeting in October 2013.
2013 EBAA YEAR IN REVIEW
CMS Confirms That Eye Banks Not Subject to the Physician Payments Sunshine Act The Centers for Medicare and Medicaid Services (CMS) issued the long-awaited rule known as the Physician Payments Sunshine Act, finalizing the details for a database that will list payments made to physicians and teaching hospitals by pharmaceutical, biologics, and device manufacturers. EBAA submitted a formal inquiry with CMS to determine if eye banks are considered applicable manufacturers, and whether they need to register and report the financial relationships with their Medical Directors to CMS.
CMS has confirmed that a traditional eye bank is not considered an “applicable manufacturer” of covered drugs, devices, biologicals, and medical supplies subject to the reporting of payments and transfers of value made to physicians under the transparency program called “Open Payments.” However, if an eye bank manufactures at least one covered device, or biological or medical supply which requires premarket approval by or premarket notification to the FDA, then it must report all payments or transfers of value, regardless of whether or not they are related to a covered product.
FDA Provides Clarification Regarding In-Process Cultures EBAA asked the Center for Biologics Evaluation and Research for clarification regarding the need for in-process cultures after validation had been performed. The Manufacturers Assistance and Technical Training Branch (MATTB) provided a reply to our inquiry, which essentially says that: Pre- and post-processing cultures of ocular tissue are necessary as part of your validation study and then periodically (i.e., quarterly) to demonstrate that your process does not introduce contamination or cause cross-contamination. In-process control and testing can serve as confirmation that the current process validation protocol remains valid.
USING DATA TO PROTECT EYE BANKING In 1999, HCFA (now CMS) proposed bundling tissue reimbursement into a single fee for corneal transplant procedures. The proposed reimbursement level was almost 40% below eye banks’ direct cost to provide tissue; this loss of revenue would have bankrupted many eye banks and would have eviscerated eye banking. To combat this proposal, EBAA hired The Lewin Group, one of DC’s most respected policy research firms, to document the prospective impact on eye banking. As a result, the proposal was dropped and the pass-through preserved. Almost fifteen years later, we face a similar situation. While there’s no proposal on the table to strip the pass-through, the country’s fiscal challenges make its continuation far from certain. For this reason, we have again hired The Lewin Group, and have directed them to update their 1999 study, while also expanding the scope of their research to address the country’s changing political and regulatory dynamics. In addition to analyzing eye banks’ real cost to recover, prepare and deliver corneal tissue to surgeons, our updated study will examine the individual and societal costs of blindness. These costs include both direct reimbursement of medical costs and the lost productivity, tax revenues, and quality of life that untreated blindness causes. By quantifying the level
14
of reimbursement necessary to sustain eye banking’s viability, and illustrating the return on investment that patients and the country derive from a successful cornea transplant, EBAA can make a compelling case for the net benefit of eye banking. This effort to quantify the net financial benefit of corneal transplants might seem jarring to members, who are committed to facilitating the gift of sight made possible by a donor or his/her family. But Congress will need to balance countless competing priorities as it tries to restore order to the country’s fiscal operations, and decisions will be made largely on the basis of return on investment. This report will give us the tools we need to address these concerns, while also emphasizing donors’ and recipients’ intensely personal stories. This study was initiated in March, and as this report goes to print, the Lewin Group has submitted a draft report for review and comment. The final report is expected in September, and will be distributed to all EBAA members, as well as to the legislators and regulators with whom we work. By anticipating this threat to our profession and arming ourselves and our allies with the data that strengthens our position, we can preserve eye banking and continue to serve tens of thousands of people each year.
EBAA BOASTS LARGEST TECHNICIAN EDUCATION SEMINAR IN HISTORY The 2013 EBAA Technician Education Seminar (TES) took place January 30 – February 2, 2013, at the Lions Eye Institute for Transplant and Research (LEITR) in Tampa, Florida. This year EBAA was excited to welcome 54 attendees from the U.S., Canada, Iran, Korea, and Saudi Arabia, making this the largest, and most globally diverse seminar in the program’s history. The TES, a four-day seminar that features lectures, demonstrations, and networking opportunities for newer technicians, is an essential part of EBAA educational programming. This year, participants had the unique opportunity to hear from a double corneal transplant recipient, Samantha Barlow, about receiving the gift of sight. As an
infant, Samantha suffered from glaucoma, cataracts, and a rare corneal disorder called Peter’s Anomaly. After receiving two corneal transplants, her sight was restored. Now 22 years old, she plans to become a paralegal. For many of the newer technicians, meeting someone who received not one, but two corneal transplants, is a great reminder of why standards and regulations are so important. Meeting Samantha also provided them with the opportunity to see someone who is using the tissue that they procure and process daily. Many attendees mentioned how thankful they were to hear Samantha’s speech, making for a great introduction to this unique and educational seminar.
TES faculty member Adam Stockman demonstrating in situ procedure
EBAA thanks Kristen McCoy, Wade McEntire, Adam Stockman and George Rosenwasser, MD, for preparing and facilitating the TES curriculum, and for dedicating so much of their time to the education of eye bank technicians. A special thanks to LEITR for hosting the seminar, and to all of the attendees who participated in this year’s TES. The seminar continues to grow and we look forward to continuously strengthening this program for the many domestic and international technicians who will attend and benefit from this important and unique EBAA program in the future!
2013 EBAA YEAR IN REVIEW
EBAA HOLDS CONTENT-RICH ND 52 ANNUAL MEETING
EBAA welcomed more than 330 attendees to its 52nd Annual Meeting at the Sheraton Chicago Hotel & Towers, June 5–8, who came in search of education, networking and other opportunities to interact with peers. In response to member suggestions, the meeting featured a revised schedule, which moved the Technician Skills Workshop from Wednesday morning to Friday morning, as well as a host of value-added enhancements. These included: The Executive Director Luncheon, which featured a session on Techniques for Establishing Tissue Agreements.
16
Additional food events, like a luncheon on Friday, which featured a discussion about EBAA’s legislative activities and how members can become involved.
Social events, like the chartered Architectural River Cruise with dinner and a view of fireworks over the Navy Pier.
Technological advancements, like the new EBAA Annual Meeting App for iPhone and Android phones and tablets; and creature comforts like more protein options at breakfast.
The Midwest Eye-Banks staff, including Heise Awardee Bradley Tennant, and Annual Meeting Host, Illinois Eye-Bank
The EBAA Meetings, Quality Assurance, Scientific Programs and Technician Education Committees, along with the Donor Development Task Force, put together an impressive program, with experts presenting on a variety of topics. This year, in addition to an array of eye bankers and surgeons from the EBAA community, a large number of external experts like Larry Johnson – author of Eight Principles of Sustainable Fundraising; Alexandra Glazier – VP and General Counsel at the New England Organ Bank; Martell
Winters – Microbiologist at Nelson Labs; Gerry Bouey – Managing Director at To Be Great Leadership Consulting; and others, brought their knowledge to the program. As the host eye bank, the Illinois EyeBank was an invaluable resource, offering suggestions for social events and entertainment, volunteering at the registration desk and in a variety of other capacities, recommending speakers, providing a customized welcome gift to attendees, sponsoring
the Architectural Cruise, and providing a great deal of other support for the meeting. EBAA is grateful to all of its 52nd Annual Meeting Sponsors and Exhibitors, a complete list of which can be found in this publication. The association looks forward to continuing to enhance our members’ Annual Meeting experience when we meet again in Portland, Oregon on June 25–28, 2014.
2013 EBAA YEAR IN REVIEW
EBAA HOLDS SUCCESSFUL 2012 FALL MEETINGS IN CHICAGO EBAA Fall Leadership Meeting The 2012 EBAA Fall Leadership Meeting in Chicago, IL, November 8–9, proved to be a success, with the Board of Directors approving a new strategic plan, the Medical Advisory Board making a number of changes to the Medical Standards, and the Accreditation Board amending site inspection requirements among the many actions taken by EBAA’s standing bodies.
Fall Educational Symposium The EBAA/Cornea Society Fall Educational Symposium was held Friday, November 9, at the Palmer House Hilton in Chicago, Illinois, with over 380 physicians, eye bankers and others in attendance. Nearly 100 papers were submitted, and 27 were selected for presentation, with eye banking efforts increasingly featured. This year, five presented papers listed eye bank staff members as co-authors, and one of those received the “Best Paper Award:” Patricia Ple-plakon’s paper “Tissue Characteristics and Reported Adverse Events After Corneal Transplantation,” was awarded “Best Paper” of the Symposium, sponsored by SightLife. Dr. Ple-Plakon’s co-authors included Roni M. Shtein, MD, David Musch, PhD, MPH, Fiorella Saponara, MD, Michael O’Keefe, CEBT, and Maria A. Woodward, MD. Drs. Shtein and Woodward and Mr. O’Keefe are affiliated with the Michigan Eye-Bank.
In addition to the papers that listed eye bank staff as co-authors, the Symposium featured a paper presented by Ellen Heck, who was the lead author on “Nucleic Acid Testing and Tissue Safety: An Eye Bank’s Five-Year Review of HIV and Hepatitis Testing for Donor Corneas,” published in the September 2012 edition of Cornea.
In addition to the selected abstracts that were presented, 2012 Paton Awardee, Jonathan Lass, MD, presented the R. Townley Paton Award entitled, “Cornea Preservation at 4°C: An American Story,” which was followed by the Paton Luncheon.
18
Rebecca Koltveit celebrates post-Run with Otte sisters [Christy Gault, Kathy Lewis, Michelle Keagle], and Dr. Kenneth Goins, who performed Rebecca’s corneal transplant
Donor wife Kathleen Fuller (middle) with Illinois Eye-Bank staff Emily Lewis (left) and Mary Schlereth
Corneal Recipient Rebecca Koltveit (second from left ) with (left to right) her friend Stacy Holman, her donor Ryan Otte’s sisters [Christy Gault, Kathy Lewis, Michelle Keagle], and Iowa Lions Eye Bank staff members Debra Schuett and Katie Charter
Run for Vision The 2012 Run for Vision 5K, held on Sunday, November 11, in Grant Park, Chicago, IL, was accompanied with brisk early-morning weather, but that did not deter the 350 excited participants. Ophthalmologists, eye bankers, trade organization employees and others supported the 27th annual event sponsored by Bausch + Lomb, yielding over $16,000 to benefit EBAA. Thanks to the support and efforts of the Iowa Lions Eye Bank and the Illinois Eye-Bank, EBAA experienced a first for the Run; a corneal recipient participated in the run with her donor’s sisters. Rebecca Koltveit, corneal recipient, eagerly ran with her donor Ryan Otte’s sisters, whom she met for the first time on race day. Donor wife Kathleen Fuller also participated in the Run, adding to the many donation awareness events she participates in with Illinois Eye-Bank.
To capture the special meeting between Rebecca and the Otte sisters, Iowa Lions Eye Bank produced a video with interviews and Run for Vision footage. Prior to the video’s distribution, Rebecca was fatally injured in a car crash. In the wake of Rebecca’s untimely passing, Iowa Lions Eye Bank edited the video to honor Rebecca. The touching video can be seen here.
Through a culmination of press releases, media advisories and outreach to local media done in conjunction with the Bausch + Lomb PR team, the Run was covered in publications such as the Cambridge Chronicle, Ophthalmology Times, Modern Medicine and the Pontiac Daily Leader. 2013 EBAA YEAR IN REVIEW
EBAA COMMEMORATES TH 30 ANNUAL NATIONAL EYE DONOR MONTH Each year during the month of March, EBAA celebrates National Eye Donor Month — a time dedicated to increasing eye donation awareness throughout the country. During the yearly commemoration, EBAA remembers and acknowledges the selfless acts of donors and their families, celebrates the lives of corneal recipients, and promotes the important work of member eye banks. This year, during the 30th Annual National Eye Donor Month commemoration, EBAA strived to not only expand National Eye Donor Month as a successful event, but as an essential element of EBAA’s mission to champion sight restoration.
20
The first National Eye Donor Month was proclaimed by President Ronald Reagan in 1983; since then, we have traditionally had a member of Congress declare the commemoration each March. The association maintained that custom this year, when U.S. Representative Alan Nunnelee (R-MS), a bilateral corneal transplant recipient and long-time supporter of cornea donation, entered the proclamation into the Congressional Record. In addition to a special webpage to aid in the expansion of National Eye Donor Month, EBAA incorporated several new items to help member eye banks plan their own events, as well as to increase eye
donation awareness beyond the transplantation community. These items included: •A copy of the first National Eye Donor Month proclamation; •A complementary information sheet to accompany corneal blindness glasses, which are used to simulate corneal blindness; •A National Eye Donor Month logo for use on websites, publications and other educational tools. A customizable version of this logo was also available to member eye banks.
Plans are already in the works to make National Eye Donor Month 2014 an even larger and more profound event.
In addition to these items, EBAA sponsored its first National Eye Donor Month activity, a story contest. Almost 30 submissions were contributed from member eye banks, with three being chosen to highlight during National Eye Donor Month and during other EBAA-related events or in publications. To view the stories selected from the story contest, please click here. The association’s National Eye Donor Month expansion efforts, and the outpouring of support for the commemoration through member eye bank events and activities, helped to realize our vision to restore sight. Some of the National Eye Donor Month achievements included a 38% increase in visits
to the National Eye Donor Month webpage during March 2013, and a 19% increase in EBAA’s Facebook fan base. Plans are already in the works to make National Eye Donor Month 2014 an even larger and more profound event. EBAA looks forward to on-going successes during future National Eye Donor Month commemorations, and in the overall advancement of the eye banking profession.
2013 EBAA YEAR IN REVIEW
IMPROVEMENTS MADE TO EBAA CONNECT EBAA Connect is EBAA’s real-time, web-based reporting and analytics engine designed specifically to collect and analyze the eye banking statistics submitted by our members. The EBAA’s Statistical Committee has been working to refine and enhance it to make it more useful to our members. These improvements include: Benchmarking tool: Accessible via the “Benchmark” tab to all users and eye banks, it provides real-time, interactive, and fully-charted insight into the average performance of all eye banks over any custom time span – from a single month to multiple years. Dashboard date feature: Enables eye banks to see when the data for a specific month has last been edited.
Tables feature: Provides eye banks a table view of data previously submitted. The table allows eye banks to present up to 12 months of data within a user-selected date range. Furthermore, a sum column has been added to show totals over the period selected. This table may be copied into Excel or other programs, may be printed, or may be saved as a PDF. New analytic reports: The launch of four new graphical reports allows members to analyze their eye bank data, and to benchmark against the average performance of all eye banks over any custom time span – from a single month to multiple years. These reports include: •R easons Tissue Not Released Due to Serologic Tests • S urgical Techniques (International) • Conversion Rate • Outcomes of Tissue
22
With access to EBAA Connect and EBAA’s transition to monthly data reporting, members can assess their data and benchmark their performance against national averages on a near real time basis, resulting in unprecedented opportunities to understand and refine their operations.
EBAA WELCOMES TWO NEW INTERNATIONAL MEMBERS The EBAA Board of Directors voted in June to accept two new International Associate Unaccredited Members— The Daqing Eye Bank, Daqing Hospital in China and the Hospital Authority Lions Eye Bank in Hong Kong. Prior to being presented to the Board, both applications were carefully reviewed and discussed by the Constitution & Bylaws Committee, which unanimously recommended both organizations for membership. Many EBAA members got the opportunity to meet Catherine Wong, Manager of the Hospital Authority Lions Eye Bank, when she attended the 2013 Annual Meeting in Chicago. Two technicians at the Hospital Authority Lions Eye Bank, Janice Wong and Galen Chow, became Certified Eye Bank Technicians in the fall of 2012. Members of the Daqing Eye Bank visited the Lions Medical Eye Bank and Research Center of Eastern Virginia earlier this year, and Dave Korroch, CEO of Lions Medical Eye
Bank and Chair of EBAA, visited Daqing in July. Mr. Korroch expressed excitement following the Board’s vote to accept the two new members, reminding the EBAA members in attendance that the action directly supports the Strategic Plan goal of increasing the number of non-U.S. eye bank and physician members in EBAA. EBAA welcomes The Daqing Eye Bank, Daqing Hospital in China, and the Hospital Authority Lions Eye Bank in Hong Kong, and looks forward to a long and mutually beneficial relationship.
On August 3, 2013 in Daqing, China, EBAA Chair Dave Korroch presented the EBAA Membership Certificate to Yaoguang Yu, MD, President of the Daqing Eye Hospital.
In November of 2012, Yaoguang Yu, MD, President of the Daqing Eye Hospital in China, visited his daughter, Liang, who teaches at Eastern Virginia Medical School in Norfolk, Virginia. While there he toured the Lions Medical Eye Bank and Research Center of Eastern Virginia. During a subsequent visit in February 2013, Daqing Eye Bank and Lions Medical Eye Bank decided to formalize their relationship; also, EBAA Chair Dave Korroch proposed that they consider applying for membership in EBAA as an International (Unaccredited) Member. Daqing Eye Bank submitted their application to EBAA in April, and the EBAA Board of Directors voted to accept their membership at the June 2013 meeting. Upon learning they were accepted as members, they invited Mr. Korroch to come to Daqing to present their EBAA membership certificate, and begin their collaborative relationship.”
WHAT’S NEW:
DEVELOPMENTS IN EYE BANKING TECHNIQUES
IMPROVING CORNEAL EVALUATION WITH A NEW BACKLIGHT CORNEA MICROSCOPY FOR EYE BANKS Written by Eric Abdullayev MD, MBA, CEBT, International Sight Restoration Eye Bank
The idea for the Backlight Cornea Microscopy occurred after working with donor corneas for several years, and thinking that the slit lamp microscope does not provide everything that can be gleaned from the cornea, including detection and evaluation of changes in all corneal layers. The slit lamp microscopy techniques shows weakness in eye bank work – initially, it was designed for the needs of ophthalmology and examination of the cornea (as a part of the eye) by reflecting light from the back of the whole eye. This approach is very weak when the cornea is removed from the
24
eye during in- situ procedure and evaluated in the eye bank — there is no back of the whole eye and only a small portion of light reflects back into the observer eye. Another weakness of the slit lamp is that the light comes from the reviewer site at an angle and only part of this light reflects back into the viewer’s eye (the rest of the slit light gets lost in the space behind the cornea). But with the new Backlight Cornea Microscopy, all light goes from behind the cornea directly into the microscope and then into observer eyes, which provides a much more powerful and detailed, real-time color of the whole cornea.
How it works The simple-to-use approach combines a standard corneal microscope with a cornea holder and a diffused light source in line behind the cornea. There are several techniques developed. Placement of the diffused light directly behind the cornea, the direct position, allows viewing of enhanced 3-D images of whole corneas with changes in all of the corneal layers. Moving the light back five or six inches, the distant position, creates an artificial “red reflex” on a donor cornea that highlights corneal
...allows an even more detailed evaluation of the cornea without staring into the microscope eyepiece.
Slit Lamp (left) and Backlight
changes, such as previous LASIK surgery. The combined view uses light sources in both locations to overlap images as needed. Created artificial “red reflex” imitates the actual “red reflex” as on live patients’ eyes. This method significantly improves the evaluation of Descemet’s folds, surgical and non-surgical corneal scars and other opacities. The artificial “red reflex” allows careful evaluation of donor corneas to locate LASIK flaps, which are easy to miss in corneas with unknown histories.
Further possibilities
Backlight microscopy-donor cornea with LASIK flap
The enhanced view provided by the Backlight Corneal Microscopy is further demonstrated by a digital video camera attachment and evaluating the images on a highresolution LCD screen. This digital component, a new generation of the eye bank workstation, allows an even more detailed evaluation of the cornea without staring into the microscope eyepiece. The screen view allows easier and faster corneal evaluations for busy eye banks whose technicians may be straining to examine many corneas each day under painful microscopes.
There is a growing worry about the growing number of donor corneas from patients who had LASIK, where even sometimes members of their family did not know about the LASIK surgery.
This method of evaluation gives the reviewer a real-time image of the cornea, which is critical. It’s not a shade or something. It’s just a real-
time image of the cornea. It’s a three-dimensional image that allows the reviewer to see the depth of the cornea. Backlight microscopy’s digital component has expanded the accessibility of donor corneas for transplant surgeons because it can allow transmission of real-time images offered by the eye bank over the Internet. That goes well beyond the standard practice of most eye banks, which generally offer only written information on the corneas to surgeons. The Backlight Cornea Microscopy can be the first major addition to corneal scanning since the slit lamp was integrated into eye bank operations midway through the last century.
2013 EBAA YEAR IN REVIEW
ADVANCEMENTS IN EYE BANKING USING OPTICAL COHERENCE TOMOGRAPHY Written by Joshua Galloway, CEBT, Lions VisionGift
While slit lamp techniques have been utilized as a means of corneal evaluation for decades, Optical Coherence Tomography (OCT) use is relatively new in eye banking. OCT devices on the market today offer a unique and highly detailed analysis of the human eye and provide an objective means of evaluating donor tissue intended for both transplant and non-transplant purposes. Fourier Domain (FD – OCT) devices on the market now offer a resolution down to 5 microns, with some ultra-high resolution devices offering 3 micron resolution. The resolution available in OCT devices may progress along with time and technology. More and more eye banks are acquiring an OCT to assist not only in evaluating pre-cut tissue for graft uniformity and pachymetry measurements, but in tissue suitability screening as well. OCT is being used more frequently to help ensure donor tissue is free from refractive surgery scars (LASIK, PRK, etc.) and from pathology such as Keratoconus, stromal dystrophies, etc.
26
It has been said that “corneal surgery starts in the eye bank” and it has never been more true a statement than over the past year. As presented at the EBAA Annual Meeting this year in Chicago, eye banks are working to be able to take OCT measurements of donor tissue in corneal viewing chambers and determine the thickness of Descemet’s membrane. While still under investigation, eye banks involved in DMEK tissue preparation and the ophthalmologists performing the surgery may find OCT can help predict the success of tissue preparation and the ease of unfolding the tissue during surgery. While many eye banks are showing success rates in DMEK preparation comparable to the success rates of surgeons, even a few corneas lost to unsuccessful preparations are too many. If OCT can be shown to reliably predict the outcome of DMEK preparation, we may be able to better utilize the precious gifts we are entrusted with before attempting difficult procedures with them. On the surgical side, OCT may provide an objective evaluation of donor tissue and allow surgeons to request tissue ideal for their patients that may be outside their normal parameters.
For eye banks involved in providing tissue to researchers, OCT can be used to provide images to researchers which were previously only available by contacting the donor’s ophthalmologist. Researchers interested in retinal diseases and glaucoma can be provided images very near to the time of death and use the information to customize their research to the specific tissue they are using. Providing this service to researchers in eye diseases has the potential to expand their scope of research and assist them in their work to eradicate blindness throughout the world. Simply stated, advances in OCT technology have allowed for greater application in the eye banking profession. Whether we consider the implications to tissue processing, the impact on gift stewardship, or the benefits to research initiatives, it is clear that the promise of OCT benefits in our profession have only begun to be realized.
Autologous Serum Drops being placed in beaker, and then bottled
IOWA LIONS EYE BANK PROVIDES AUTOLOGOUS SERUM EYE DROPS Written by Garret Locke, CEBT, Iowa Lions Eye Bank
The Iowa Lions Eye Bank (ILEB) began preparing Autologous Serum Eye Drops (ASED) in April 2005, at the request of the University of Iowa Hospitals & Clinics’ Department of Ophthalmology’s Cornea Service. Physicians identified a growing need experienced by cornea patients suffering from persistent epithelial defects (PEDs), among other ailments, and attempted to work with the local blood bank and pharmacy to assist them. However, primarily due to an anticipated low volume, the interest level by these services remained low. Nonetheless, the need for those patients who were losing their sight was not diminished. After investigating regulatory requirements, ILEB developed its program and began providing this service. Low start-up capital requirements and existing laminar flow hood environments make an eye bank an ideal organization to provide this service. The autologous serum solution is a combination of 20% serum and 80% balanced salt solution (BSS). The role of ILEB is to receive the blood specimens drawn from the patient, centrifuge the blood to separate red blood cells from
serum, dilute with BSS, vacuum filter, bottle and label. Some patients require only the initial treatment, while others will utilize the drops on a recurrent basis. Often, all other treatments have been exhausted. Unfortunately, insurance does not cover the cost of the treatment which typically provides roughly a three to six month supply. There are several schools of thought as to why autologous serum stimulates the re-growth of the cornea epithelium. Serum provides nerve growth factors (NGF), enhances cell migration and adhesion due to neurotrophic and epithelium maintaining factors, and supplies neurotransmitters as well as beneficial proteins. Through the first four years of the program, the number of treatments provided more than doubled biennially, peaking at 118 in 2009. Over the past five years, an average of nearly 90 dilutions per year had been performed and more surgeons from around the state began to take advantage of this process. While this procedure is being performed in a few doctor’s offices, ILEB was the first eye bank in the United States known to begin providing this service and has since
presented on the topic twice at Eye Bank Association of America (EBAA) Annual Meetings. The presentations spawned an interest by many other eye banks and surgeons which led to the development of a training program. Several other eye banks have utilized this training program to initiate their own ASED service. Due to FDA and interstate shipping regulations, eye banks can only provide this service within their own state. Fortunately, with the onset of so many other eye banks beginning to provide this service, the preparation of ASED is quickly becoming another service provided within the eye banking community. Provision of the drops can clearly be seen as an extension of the sight restoration efforts the community can provide to fulfill EBAA’s vision of restoring sight.
2013 EBAA YEAR IN REVIEW
AWARDS AND HONORS LEONARD HEISE AWARD
Bradley Tennant, BA, CEBT
The Leonard Heise Award is presented to a non-physician eye banker in recognition of his/her outstanding devotion to EBAA’s development and for exemplifying the precepts of Leonard Heise, a major contributor to the fight against blindness and one of the founders of EBAA. This year, the Heise Award was presented to Bradley Tennant, Midwest-Eye Banks. Brad has 26 years of dedicated service in eye banking, and has been a Certified Eye Bank Technician (CEBT) since 1988. Although he began his tenure at the Michigan Eye-Bank as an eye bank technician, he has served in various capacities including Manager, Laboratory Operations and Senior Laboratory Manager. Brad was promoted to Vice President, Clinical
28
Operations for Midwest Eye-Banks in 1999. In 2007, he became Midwest Eye-Banks’ Senior Vice President, as well as the International Program Director in 2010. Brad has served on various boards and committees of EBAA, including the Medical Review Sub-committee, the Legislative & Regulatory Affairs, International Relations, and Exam Committees, as well as the Medical Advisory Board and Accreditation Board, on which he served as Secretary and Co-Chair, respectively. Brad has presented at a variety of meetings in the U.S. and internationally.
R. TOWNLEY PATON AWARD
Jonathan Lass, MD Dr. Lass’ Paton Lecture
The highest honor for corneal physicians, the R. Townley Paton Award is presented annually to an ophthalmologist in recognition of his/her outstanding contribution to EBAA’s development. Since 1982, esteemed corneal physicians who exemplify the precepts of R. Townley Paton, MD, the father of modern eye banking and the founder of the first eye bank established in the United States, have received this notable award. The 2012 Paton Awardee was Jonathan Lass, MD. Dr. Lass is the Charles I. Thomas Professor and Chairman of the Department of Ophthalmology and Visual Sciences at Case Western Reserve University (CWRU) in Cleveland, Ohio, Director of University Hospitals Eye Institute, Medical Director of the Cleveland Eye Bank, and Medical Director of the Case Cornea Image Analysis Reading Center. He joined the faculty at CWRU School of Medicine and the medical staff of University Hospitals in 1979 and became chair of the Department in 1993. Dr. Lass is currently on the editorial
board of the journal, Cornea, and received the Senior Honor Award from the American Academy of Ophthalmology in 2004. He has research interests in the area of corneal physiology and immunology, genetics, cornea image analysis, and clinical trials of corneal disease with over 200 publications with active funding from the National Eye Institute (NEI) for these studies. Dr. Lass contributed to major advances in corneal preservation and transplantation including the NEI-funded Cornea Donor Study determining that donor age does not impact transplant survival, but does impact endothelial cell loss. He is the study chair of the NEI funded multi-center prospective trial, the Cornea Preservation Time Study, which is examining the effect of preservation time of the donor cornea on graft survival and endothelial cell loss following endothelial keratoplasty.
2013 EBAA YEAR IN REVIEW
MY FELLOWSHIP EXPERIENCE Written by Raquel Campos Galvão de Queirós, MD Banco de Olhos do Hospital de São José, São José, Brazil
Living in a country like Brazil, where most of the Eye Banks belong to the Government and always have to work with lack of resources, can sometimes be very hard. We many times have to have extra effort to give the best tissue possible to the receiver with what we have. That’s why the experience on the MJO’s Fellowship was so important to me. It was simply awesome! I was very well treated by everyone either at the EBAA Annual Meeting or inside the Illinois Eye-Bank, during the whole fellowship. Beginning the fellowship with the Annual Meeting
30
was particularly very important to me, because the subjects discussed in it were a very good introduction of how the Eye Banks’ work in the USA. I could get used to some terms, rules and political problems that the Eye Banks are facing before starting the fellowship. It helped me a lot to understand how the process of donations works. Chicago is a great city, and the Illinois Eye-Bank, a very well organized and amazing eye bank. I will, for sure, use all that information that I have learned there on my day-by-day work at our Eye Bank here in Brazil. The opportunity of knowing the Michigan
Eye-Bank, and also the Gift of Hope Institution was also great! Learning about how to manage the specular microscope, since our eye bank still doesn´t have one and is trying to get it soon, was essential to my training. Now, I will be able to teach our technicians how to work with it. The protocols used at the eye bank for each procedure were just great. They were similar to ours, but more complete. I am planning to use them to improve our work here. The forms used for Patient’s Clinical
History and Slit lamp Evaluation will be very helpful for us, too. Watching the pre-cut procedures, to prepare tissues for Endothelial Keratoplasty, was really amazing, but probably I won’t have the opportunity to have that kind of work at our eye bank since we won’t be able to have the microkeratome. The wet lab performed in the end of the Annual Meeting was also great, because I could see and do some pre-cuts by myself with the microkeratome and also learn about how to prepare DMEK tissues. DMEK is a surgical technique that, since it doesn’t use technology,
just regular surgical instruments, is a “cheap” way to perform Endothelial Keratoplasty in poor hospitals like the one I work in, despite of the difficulties of the technique. But I believe that, after a good training, I will be able to start doing it on my patients. All I could see, the procedures I could watch, the people I could talk to, and finally, all I could learn in this wonderful experience will help me a lot not just as a Medical Director of an Eye Bank, but also as an ophthalmologist, a cornea surgeon and mainly, as a human being. I will carry it with me for all my life. Thank you, all the EBAA staff, the Illinois Eye-Bank and Michigan Eye-Bank
and Gift of Hope’s professionals!! You are great! My special thanks to Stacey Gardner, a very kind and patient professional, who helped me a lot to getting this fellowship, and to all my new friends forever: Diane Hollingsworth, Elsa Arteaga, Kristen McCoy, Mary Schlereth, Emily, Cheryl, Serena, and Dalene. These people will always be in my heart and have my gratitude!! MJO fellowship was an extraordinary experience and turned the feeling of frustration that I used to have before into hope. Thank you all for that!
MARY JANE O’NEILL FELLOWSHIP IN INTERNATIONAL EYE BANKING The Mary Jane O’Neill (MJO) Fellowship in International Eye Banking was established in 2001 in order to provide medical and technical personnel from eye banks in developing countries with the skills necessary to develop, operate, and maintain successful eye banks —ultimately, reducing blindness due to corneal disease
or injury. Each year, the Fellowship brings an individual to the United States to intern at an EBAA eye bank in order to learn the practice of eye banking through the clinical, technical and business aspects of the U.S. eye banking systems. The 2013 MJO Fellow, Raquel de Quieros, MD, wrote a personal account of her experience.
MJO Fellow Raquel de Queirós during the Annual Meeting Architectural Cruise with Diane Hollingsworth, Executive Director of Illinois Eye-Bank
2013 EBAA YEAR IN REVIEW
PATRICIA AIKEN-O’NEILL SCHOLARSHIP RECIPIENT The Patricia Aiken-O’Neill (PAO) Scholarship is a merit-based scholarship designated to provide funds for an eye bank staff member to attend the EBAA Annual Meeting. Kate Davis, a Recovery Technician for Lions VisionGift, was chosen as the 2013 recipient. Ms. Davis has been an employee of Lions VisionGift in Portland, OR, for five years. Prior to her tenure at Lions VisionGift, Ms. Davis worked as an environmental specialist in Southern California and the State of Oregon, as well as a 10-year stint as a Forensic Toxicologist in the 9th District Federal Courts of Southern California. She acquired her Bachelor of Science degree in Biology from Oregon State University in 1993, and worked simultaneously for the Environmental Protection Agency in Environmental Toxicology. “Kate has performed over 700 eye donor recoveries. While technically proficient, more importantly, she is a great ambassador of eye donation. Kate is a teacher and powerful advocate for eye donation. She has been given good skills and training by our organization to do her job, but there is no substitute for attending an EBAA meeting to add depth of knowledge to her teaching tool kit. Any information gleaned from this opportunity would be returned to the community 700 times over.” —N omination statement by Barbara Crow, Executive Director, Lions VisionGift
32
RICHARD LINDSTROM
EBAA RESEARCH GRANTS: In 2013, EBAA awarded $45,814 in funds to the following EBAA/Richard Lindstrom Research Grant recipients. Research grants are awarded annually to provide support for proposals specifically concerned with issues directly related to eye banking and/or corneal transplantation. The EBAA research grant program is made possible by the Lindstrom Fund for Corneal Research.
“Gene Therapy to Protect Cornea During Storage After Transplantation” – $10,000 Thomas Fuchsluger, MD, FEBO, Lions Eye Bank North Rhine-Westphalia
Aim of the Study: To increase the safety of gene therapy and to reduce the immune reactions triggered by the viral vector and to perform functional, immunological and biosafety tests to improve the survival rate of donor corneas during eye banking and after transplantation.
“Nanoparticle Based Targeted Therapy of Corneal Inflammation” – $10,000 Quingguo Xu, PhD, Wilmer Eye Institute, Johns Hopkins University
Aim of the Study: To develop and characterize the hybrid PLGA/ dendrimer-dexamethasone (PLGA/ D-dex) nanoparticle formulation and to study the biodistribution of PLGA/D-dex nanoparticles after a single subconjunctival injection in an alkali-burn corneal inflammation rat model.
“Role of Integrins MAdCAM-1 in Corneal Transplantation” – $9,314 Hamidreza Moein, MD, Schepens Eye Research Institute
Aim of the Study: To determine the following: 1) if MAdCAM-1 and VCAM-1 are upregulated in the vascular bed of the cornea and if their ligands are upregulated in DCs after corneal transplantation; 2) the functional role of MAdCAM-1 and VCAM-1 by studying rolling, adhesion and migration of DCs in mouse corneal allotransplantation model and 3) the effect of MAdCAM-1 and VCAM-1 blockade on the corneal graft survival.
“Erythropoietin for Re-innervation after Transplantation” – $6,500 Shruti Aggarwal, MD, Massachusetts Eye and Ear Infirmary
Aim of the Study: To assess the presence of Erythropoietin receptors (EPOR) in the cornea; evaluate the efficacy of Erythropoeitin (EPO) as a corneal neuroprotective agent and elucidate the effect on cornea re-innervation; and assess if EPO can promote graft survival.
“In vivo Imaging-guided Risk Assessment for Corneal Graft Rejection in Dry Eye Disease” – $5,000 Jing Hua, MD, Schepens Eye Research Institute
Aim of the study: To determine the correlation between APC maturation and morphological parameters in DED and to determine predictive value of pre-operative in vivo imaging for graft rejection.
“The Use of Rapamycin as an Additive to Corneal Storage Media” – $5,000 Behard Milani, MD, University of Illinois at Chicago
Aim of the Study: To test rapamycin as an additive to corneal storage media by determining if rapamycin can enhance the viability and lifespan of corneal epithelial and endothelial cells while maintained in Optisol and by determining if corneal epithelium stored in rapamycin has increased clonogenic potential in vitro.
2013 EBAA YEAR IN REVIEW
Networking grants are awarded annually to promote an educational interchange of ideas between eye banks.
NETWORKING GRANTS Networking grants are awarded annually to promote an educational interchange of ideas between eye banks. The Executive Committee awarded grants of $1,500 each to Arkansas Lions Eye Bank and Laboratory and Louisiana Lions Eye Bank.
34
Arkansas Lions Eye Bank and Laboratory will visit Michigan Eye-Bank to learn about their EK tissue processing program. The goals of Arkansas Lions Eye Bank and Laboratory are to gain hands-on experience with EK tissue preparation, learn about the equipment needed, and to ultimately define a protocol for preparing tissue for EK.
Louisiana Lions Eye Bank (LLEB) will use the grant award to visit two different eye banks. LLEB will visit Baton Rouge Regional Eye Bank to learn about their Quality Assurance program, and they will visit Southern Eye Bank to observe their tissue pre-cutting program.
OUR SUPPORTERS EBAA wishes to thank the following organizations whose material and financial contributions throughout the year have supported EBAA’s vision to restore sight worldwide. Our efforts would not be possible without their support. 2013 Annual Meeting Sponsors
2013 Annual Meeting Exhibitors
Abeamed, Inc.
AmericanPharma Technologies
MNX Global Logistics
Bausch + Lomb
Axis Global Logistics
Moria, Inc.
HAI Laboratories, Inc.
Bausch + Lomb
Illinois Eye-Bank
BioD, LLC
National Disease Research Interchange
International Journal of Eye Banking
Cardinal Health
Network Global Logistics
Konan Medical USA, Inc.
Donate Life Rose Parade Float
Numedis, Inc.
Lions VisionGift
ECL2/Q-Pulse
Ocular Systems, Inc.
Midwest Eye-Banks
Haag-Streit USA
Prescott’s, Inc.
MNX Global Logistics
HAI Laboratories, Inc.
Providence Packaging
SightLife
ICCBBA
QualTex Laboratories
Transplant Connect
International Journal of Eye Banking
Quick International Courier
Vision Share
Jim Colyn & Associates Quality Consultants, LLC
SightLife
Konan Medical USA, Inc.
Stephen Instruments
Krolman
Transplant Connect
LABS, Inc.
ViroMed Laboratories
Med-Logics, Inc.
VRL Laboratories
Statline
Midwire Systems/Donor Service Center 2013 EBAA YEAR IN REVIEW
FINANCIAL DATA Revenue g Member dues
$ 1,265,340
g Meeting Registration
$ 353,435
g Accreditation Fees
$ 112,250
g Technician Exam/Recertification
$ 102,775
g Other Contributions
$ 323,347
Total
$ 2,157,147
Expenses g Member Services
$ 962,395
g Meetings
$ 408,350
g Accreditation
$ 112,007
g Administrative
$ 452,411
Total
$ 1,935,163
36
STATISTICAL REPORT EBAA’s 2012 Eye Banking Statistical Report* is the world’s most comprehensive examination of eye banking performance and trends in existence. This year’s report has been reorganized to correspond to the data elements in EBAA Connect, and includes information on all 80 U.S. member eye banks and 8 international eye banks. New this year is the annual comparison of the domestic use of U.S. supplied intermediate-term preserved tissues showing that endothelial keratoplasty (EK) is performed more than penetrating keratoplasty (PK) in the U.S. for the first time. At the request of the corneal surgeons, Woodford Van Meter, MD, has included the indications for keratoplasty tables to his analysis, calculating the types of keratoplasty procedures performed for each given diagnosis.
In 2012, domestic eye banks reported 116,990 total tissue recoveries, an increase of 2.3% from 114,348 recoveries in 2011. This is the fourth time that over 100,000 tissues were recovered in a single year. Total donors in the United States were 59,221, up 2.4% from 2011. The total number of U.S. supplied tissue distributed for keratoplasty (including long-term preserved tissue) was 68,681, a 1.6% increase from 67,590 in the previous year. There were 19,546 corneas exported internationally in 2012, compared to 18,307 in 2011, a 6.8% increase. In the U.S., the reported number of corneal transplants performed in the United States increased from 46,196 in 2011 to 46,684 in 2012 (1.1%). The increasing trend in the number of corneas provided for EK procedures continues. In 2012, 23,049 corneas were provided for EK procedures in the U.S., (a 6.9 % increase) and 1,976 corneas were provided for
EK internationally. In contrast, 21,422 corneas were provided for PK procedures in the U.S. (0.9% decrease from 2011) and 15,294 were provided for PK internationally (5.3% increase). The Eye Banking Statistical Report would not be possible without the active participation and support of all our members. The Statistical Report is a valuable and useful resource for eye banks to review their operational efficacy and to drive performance improvement efforts.
*This document can be accessed in the members-only section of EBAA’s website. 2013 EBAA YEAR IN REVIEW
LEADERSHIP BOARD OF DIRECTORS 2012–2013 Executive Committee
Chair David Korroch, CEBT
Chair-Elect David Glasser, MD
Immediate Past Chair Marian Macsai, MD
Secretary Donna Drury, MBA, CEBT
Treasurer Woodford Van Meter, MD
Ex-Officio, Per Article 4.6
Executive Committee At-Large Members
Medical Advisory Board Chair Michael Nordlund, MD, PhD
Jim Quirk, CEBT
President & CEO Kevin Corcoran, CAE
Doyce Williams, CEBT
Board of Directors At-Large Members
Michael Nordlund, MD, PhD
Cynthia Reed, PhD
Appointed Per Article 4.2 E: AAO Representative
Woodford Van Meter, MD
38
Kevin Ross, MS, MPH
Mary Gatien, RN, CEBT, CTBS
Chris Stoeger, CEBT, CTBS
Appointed Per Article 4.2 D: Designated by the Board
Bernie Iliakis, CEBT
Jackie Malling, CEBT
Jim Quirk
Doyle Stulting, MD, PhD
Appointed Per Article 4.2 G: Honorary Board Members
John Guckes
Mark Mannis, MD
Representatives by Size of Eye Bank Representative: Small Eye Bank
Representatives: Medium Eye Bank
Jay Lugo, CEBT, COT
Victoria Adler, RN, CEBT
Jim Wagner, CEBT, CTBS
Representatives: Large Eye Bank
Doyce Williams, CEBT
Jason Woody, CTS, CEBT
2013 EBAA YEAR IN REVIEW
Committee Chairs Accreditation Board Co-Chairs: W. Barry Lee, MD Jim Quirk, CEBT
International Relations Committee Co-Chairs: Jeffrey Penta, CEBT Jeremy Shuman, CEBT
Vice Chairs: Eric Meinecke, CEBT Neda Shamie, MD
Legislative & Regulatory Committee Chair: Rusty Kelly, CAE
Certification Board Chair: Patrick Gore, RN, CEBT
Vice Chair: Cindy Reed, PhD
Constitution & Bylaws Committee Chair: Bess Beliveaux, CEBT Continuing Education Committee Chair: Michael Tramber, CEBT Donor Development Taskforce Chair: Sara McFee, APR Vice Chair: Katie Charter, CEBT Exam Committee Chair: Edwin Roberts, CEBT Finance Committee Chair: Woodford Van Meter, MD Heise Committee Chair: Dean Vavra, CEBT Vice Chair: Bruce H. Varnum
40
Medical Advisory Board Chair: Michael Nordlund, MD, PhD Vice Chair: Jennifer Li, MD Medical Review Subcommittee Chair: Sean Edelstein, MD Meetings Committee Chair: Corrina Patzer
Quality Assurance Committee Chair: Kristin Mathes Vice Chair: Janice Ableson, RN Scientific Programs Committee Chair: Stephen Kaufman, MD, PhD Vice Chair: Neda Shamie, MD Statistical Report Taskforce Chair: Brian Philippy, CEBT Vice Chair: Caroline Ulrickson, CEBT Technical Procedures Manual Subcommittee Chair: Michael Tramber, CEBT
Vice Chair: Chuck Pivoney, CEBT
Technician Education Committee Chair: Jay Lugo, CEBT, COT
Paton Committee Chair: Alan Sugar, MD
Vice Chair: Kristen McCoy, CEBT, CTBS
Policy & Position Review Subcommittee Chair: Shahzad Mian, MD Vice Chair: Amanda Nerone, CEBT
EBAA Staff
President & CEO Kevin P. Corcoran, CAE
Vice-President of Member Services Molly Georgakis
Director of Finance Bernie Dellario
Director of Regulations and Standards Jennifer DeMatteo, MCM, CIC
Manager of Communications Patricia Hardy
Manager of Education Programs Stacey Gardner
Legislative Consultant Tom Bruderle
2013 EBAA YEAR IN REVIEW
1015 18th Street, NW Suite 1010 Washington, DC 20036 T 202.775.4999 F 202.429.6036 www.restoresight.org