Workshops, science and WHO initiative ensure record attendance at EEBA

More than 300 guests from all over the world came together at the XXXII Annual Meeting of the European Eye Bank Association (EEBA) in Hannover.

How can eye banks and tissue donation organisations contribute to preventing avoidable blindness?

This question was addressed by tissue bank employees, doctors and scientists from over 30 countries at this year’s annual conference of the EEBA, which took place from 16 to 18 January 2020 in Herrenhausen Palace in Hannover.

The focus topic of the event was based on the worldwide initiative VISION 2020, which had already been launched in 1999 by WHO (World Health Organisation) and IAPB (International Association for the Prevention of Blindness) to prevent avoidable blindness. This year, the German Society for Tissue Transplantation (DGFG) hosted the conference bringing together experts from the field of corneal medicine in different European cities every year. The choice of venue was not coincidental: The DGFG has had its headquarters in the capital of Lower Saxony since its foundation in 2007.

The cornea

The cornea is about half a millimeter thick and is our window to the world: It lets light into the eye and thus enables good vision. About 7,000 corneal transplants per year in Germany are the last chance for patients with irreversibly clouded corneas due to illness or injury to see clearly again. Such a transplant comes from the tissue donation of a deceased person, which the DGFG carries out from over 30 locations and at more than 100 donor hospitals nationwide.

About European Eye Bank Association (EEBA)

The EEBA was founded in 1989 with the aim of providing corneal banks with an information platform. Today, the association is the leading association in Europe with more than 80 corneal banks and clinical centres from more than 20 European countries and several countries outside Europe. Its mission is to contribute to ensuring that tissues and cells of optimal quality and safety for transplantation and the treatment of eye diseases are provided according to the highest medical and scientific standards and that they are available in an ethical and humanitarian manner to as many patients in need as possible, in accordance with the Helsinki Declaration and applicable national and international laws and regulations. (Annual Directory, 28^th Edition)

16 January: Kick-off with extensive workshop and training programme

The event started with an extensive workshop and training programme.

In the evening, the conference was officially opened at the so-called Welcome Reception. Martin Börgel (managing director of the DGFG) and medical ethicist Professor Eckhard Nagel (Institute for Medical Management and Health Sciences of the University of Bayreuth) welcomed the guests. Professor Nagel also picked up on the latest decision in the German Bundestag and underlined the importance of this conference in order to exchange information about initiatives in the supply of corneal transplants beyond Europe.

A highlight on the programme of this first evening was the exhibition of the 18 submitted artworks for the Photo & Art Contest: For the first time, EEBA together with the DGFG organised a contest, which offered guests an insight into the world of corneal donation, preparation and transplantation and was intended to raise public awareness of the topic of “seeing” beyond the event. Both laymen and experts from tissue banks and member organisations of the EEBA creatively addressed this topic. Oil paintings, video slideshows, mobile, microscope images, photomontages and portraits – the artists’ perspectives are as varied as their submissions to the competition.

An international jury of six judges selected the winner of the main prize from the 18 entries. Members of the jury were: Marion Charlotte Renneberg (Medical Association of Lower Saxony), Rebecca Zimmering (Federal Center for Health Education/BZgA), Renate Kastrowsky-Kraft (Lions Governor District 111 Lower Saxony-Hannover), Simone Henzler (German Blind Relief Organisation), Aleksandra Jones (The Ophthalmologist) and Dr. Simone Hennerbichler (Austrian Red Cross)

“To be a part of Lions’ international commitment to eye health is why I’m here. I would like to inform myself about corneal donation and eye banks, which Lions also support in Germany,” says Renate Kastrowsky-Kraft, District 111 Governor of Lower Saxony/Hanover, describing her motivation to participate in the EEBA 2020 in Hannover. The district governor actively supported the conference as one of six jurors of the Photo & Art Contest.

“I find this contest very interesting. The art provides access to the topic and a discussion platform with very different people – not only experts”.

Workshop
Limbal stem cell transplantation
Experts from all over the world devoted a two-hour round table to the topic of limbal stem cell transplantation. Doctor Vikas Mittal, ophthalmologist from India, presented the SLET (Simple limbal epithelial transplantation) method and showed the possibilities that cell transplantation offers patients.
Wetlab
Techniques for Lamella Preparation
During the wetlab Techniques for Lamella Preparation, eye bank employees learned about the liquid bubble technique, a special preparation method for corneal lamellae, and tried out the method for themselves.

Wetlab
Workshop

Slit Lamp
Especially conspicuous features in donor corneas were examined more closely during the Slit Lamp Workshop. The workshop leaders gave the participants tips and tricks on how to use the slit lamp for diagnostics and quality control of corneas in the tissue bank.
Workshop
Cell Counting
The cell counting workshop dealt with various cell images of a cornea. The cell count is still considered the number one quality parameter for corneas. Therefore, correct counting and recognition of the cell structure is of great importance for the technicians in the eye banks.

Workshop
Workshop
Donor Consent
The Donor Consent Workshop focused on the challenges of next of kin interviews and the basic clarification of how obtaining donor consent works in different countries. While most countries in the EU have already established an opt-out solution, the extended consent solution (opt-in) is still in force in Germany, for which the majority of members of the German Bundestag voted again on the same day, January 16th. The participants discussed case studies and jointly considered possible solutions to master even difficult next of kin interviews.
Workshop
Donor Cases
In addition to the three technician workshops, tissue donation coordinators also had their money’s worth: Special medical donor cases were presented in the Donor Cases Workshop. In teams, the participants developed solutions and discussed them in a plenary session. Medical screening is always the beginning of every tissue donation and is also decisive for its success.

Workshop
Workshop
IT
In an IT Workshop, software solutions for tissue donation organisations and eye banks were discussed. Those data banking systems should efficiently bundle and structure the work and approval processes. In practice, such solutions save not only paper but also time.
Workshop
Fundraising and Promotion
In the Fundraising and Promotion Workshop, the participants looked at best practice examples of PR campaigns and charity activities and discussed do’s and don’ts in public relations and fundraising. For tissue donation organisations and eye banks, the financial resources for e.g. research projects are limited, which is why fundraising and sponsoring can be a suitable way of gaining financial resources.

Workshop

17 January: Scientific programme with a culinary and artistic end at the Gala Dinner

The second day of the EEBA conference was opened by Doctor Thomas Brunotte of the Volkswagen Foundation. The Volkswagen Foundation is the initiator of the reconstruction of the historic Herrenhausen Palace, which was the summer residence of the Hanoverian royal family in the 19th century. Professor Iva Dekaris, President of the EEBA, gave an insight into the overall performance of the member organisations: Around 40,000 corneal donations are processed in eye banks in the EU every year, of which about 70 percent are released for transplantation. The proportion of lamellar corneal transplants is now around 22 percent. Professor Philip Maier, head of the Tissue Transplantation and Biotechnology Section of the German Ophthalmological Society, addressed the importance of local cornea banks and joint exchange on an international level. Finally, Martin Börgel, chair of this year’s conference, welcomed the guests and drew attention once again to the audience prize of the Photo & Art Contest, for which voting could be held later in the evening. In addition, he prepared the participants for further interaction: For the first time, the audience was able to vote for the best speaker after each session using their smartphones. All session winners received an illustrated book from the DGFG, which documents the corneal donation in 25 powerful images.

The opening ceremony was followed by the so-called Annual Memorial Lecture in memory of the co-founder and first president of the EEBA Niels Ehlers, who died in 2016. Niels Ehlers made many important contributions to ophthalmology and particularly promoted the development of the Danish Corneal Bank in Aarhus. The lecture was held by Professor Frank Wilhelm (ophthalmologist from Greifswald and responsible person of the Cornea and Tissue Bank Schwerin), who was briefly introduced to the guests by Professor Viestenz (Eye Clinic of the University Hospital Halle/Saale). Professor Wilhelm himself helped to establish three cornea banks in Germany and thus made an essential contribution to the supply of corneal transplants in Germany.

In the subsequent scientific sessions on Friday and Saturday, a total of 38 scientists presented research results on the topics of quality management and corneal storage, processing, corneal transplantation, new applications in ophthalmology, innovation and tissue donation.

Award ceremony for the Photo & Art Contest on the evening of the Gala Dinner

In the run-up to the conference, the jury already selected the five best works of art, which thus qualified for the main prize. All nominated works were also exhibited again on the evening of the Gala Dinner in the Old Town Hall. Martin Börgel and Iva Dekaris announced the two winners of the art contest: The main prize was won by the assistant doctor Marie Elisabeth Burghardt of the eye clinic at the University Hospital Halle/Saale with her work {kornea:}. Her work focuses on portrait photographs of researchers and surgeons of the University Eye Hospital Halle, whose interest is dedicated to the cornea. The portraits show simulated visual impairments as described by patients. The prize, which is endowed with 1,000 euros and sponsored by the EEBA and DGFG, was generously supported by Lions Germany. The audience award of 500 Euro, donated by GO! Express & Logistics, was won by the team of the Laboratory Biology, Engineering and Imaging of Corneal Grafts (BiiGC) of the Medical School of Saint Etienne with their spectacular microscope images under the title The corneas you have never seen.

18 January: Conference ends under the sign of VISION 2020

On the last day of the conference, the experts addressed the question of how eye banks and tissue donation organisations can contribute to the fight against avoidable blindness in connection with VISION 2020. The sessions on international developments formed the highlight and conclusion of the conference: In his presentation, Professor Nagel focused on blindness prevention beyond national borders and highlighted the acute need for action. According to the WHO World Report on Vision (2019), more than one billion people worldwide suffer from eye diseases, including more than four million people with corneal diseases (p. 26), caused by injuries, infections or vitamin A deficiency in children (p. 7). Professor Nagel would welcome global ethical guidelines on the handling of tissue donation, processing and allocation in order to prevent a possible economisation of tissue donation worldwide. Among other things, he calls for disclosure of the origin and ultimate use of the donated tissue, as transparency is the basis of a culture of trust necessary for this.

Eye banks are the key to advancing and improving corneal donation and ultimately patient care with corneal transplants in countries in need. India, where most people affected by blindness live, showed how it could be done: The country has managed to successfully establish eye banks and corneal transplants as a form of therapy. Doctor Manisha Acharya from Dr. Shroff’s Charity Eye Clinic in New Delhi also reported on this issue.

Professor Viestenz, who trains ophthalmologists in corneal transplantation several times a year in Peru, and Professor Wilhelm, who in turn has already successfully trained several ophthalmologists in Cameroon, reported on training programmes in corneal transplantation. The experts agreed that it is important to establish sustainable donation programmes and eye banks locally and to offer short, intensive training sessions in order to achieve long-term success. The provision of tissue and medical equipment from Germany only helps shortly and cannot lead to sustainable success in preventing corneal-related blindness. Doctor Elisante Jackson Muna from Tanzania also made this clear in his presentation. In many African countries, faith plays a decisive role. For religious reasons, there are often reservations regarding tissue donation that need to be overcome. Rizwana Peerbhoy of the Lions SightFirst Eye Hospital in Nairobi also highlighted this problem. At her clinic, patients with corneal diseases from all over Kenya and East Africa are treated. Again, the biggest problem is finding donors.

Networking & awareness through travel grants & fundraising

The exchange of experience with experts from Africa and India was made possible by donations, which were used to finance travel expenses. In the run-up to the EEBA, the Lions Clubs Hannover-Expo and Wedemark supported the DGFG’s request to invite experts for this international programme to Hannover. The LC Wedemark had already donated 1,500 Euro last year for international networking purposes (see LION issue October 2019). In order to continue such an international exchange, however, more travel grants are needed. The DGFG wants to continue its efforts in this area in the future and raise funds.

Doctor Graeme Pollock, director of the Lions Eye Donation Services from Melbourne, closed the discussion-packed Saturday with his presentation Ethics in tissue donation networks and showed, also on the basis of already existing guidelines such as the Barcelona Principles, that the basis for international action according to ethical principles is given. These can be used in the future for aid projects.

The EEBA 2020 was certainly an important impetus not only to work to the highest standards in tissue medicine in Europe, but also to think outside the box and identify global needs. The DGFG would like to thank all participants and exhibitors from the industry who contributed to the success of this XXXII Annual Meeting of the EEBA. Next year, the EEBA community will be heading to the UK: EEBA 2021 will take place from 4 to 6 March in Liverpool!

See & download all EEBA photos

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