Corneal Transplantation in the Developing World: Lessons Learned and Meeting the Challenge.
OBJECTIVE
To describe the current state of corneal blindness (CB) and corneal transplantation in the developing world.


METHODS
Information on corneal transplantation was obtained from published articles, direct communication with corneal specialists in developing countries, data sourced from eye banks in the United States and abroad, and personal experience.


RESULTS
CB is the fourth leading cause of global blindness. Most of those with CB live in India and Africa. Many developing countries lack sustainable eye banks, and there is a shortage of corneal transplant surgeons. India has started programs to address both these issues, whereas Africa seems the least prepared. Brazil and the Philippines have also made significant progress in eye banking. In addition, studies indicate a role for the use of a keratoprosthesis in select settings. Several international organizations and academic centers have targeted these system-wide deficiencies.


CONCLUSIONS
There are an unacceptable number of people with cornea blindness in the developing world. Programs have been initiated to address eye bank sustainability and to increase surgeon capacity. However, much more work and effort will be needed to improve the current statistics.
Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, MA.
Roberto
R
Pineda
D001766:Blindness / Q000534:rehabilitation*; D003318:Corneal Opacity / Q000601:surgery*; D016039:Corneal Transplantation; D003906:Developing Countries; D014943:Global Health; D006801:Humans