As part of a transformation to one of the pioneering eye banks in the country, Tissue Banks International (TBI) recently underwent a formal rebranding, changing its name to KeraLink International. This move included shedding the musculoskeletal portion of operations to concentrate on dramatically increasing the number of sight-saving procedures performed globally, explained Douglas Furlong, KeraLink’s president and chief executive officer.
The new name is formed from “kera,” short for kerato (evoking the cornea), and “link” for all of the links that must come together—surgeons, researchers, benefactors, donors and their families, and recipients—to achieve the goal of reversing corneal blindness through transplantation, Furlong said.
The restructuring and rebranding resulted from a review of operations begun by the board of directors in 2014, he explained.
Though the musculoskeletal program was successful, the board concluded that divesting it and returning to the organization’s roots would do more to address unmet health needs around the world.
Supporting unmet demand
While eye banks in the United States collectively are meeting the need for corneal tissue domestically, outside of this country the unmet demand is significant. More than 10 million patients are awaiting transplants, and in the developing world, many of them are children and young adults.
Proceeds from the 2015 sale of the musculoskeletal division are now being invested in strengthening KeraLink’s efforts to improve this situation, while at the same time expanding the reach and breadth of its work in the United States.
“We’re all about supporting research that may have an impact in the future, but we’re also about trying to do what we can right now to try to be impactful where we can,” Furlong said.
The results are already evident.
In 2016, KeraLink spent more than $3.5 million to enhance its operations in the United States and abroad, including outfitting a new facility in Baltimore that serves as the organization’s global headquarters and mid-Atlantic center. The headquarters allows for 24/7 evaluation and preparation of tissue, includes two class 100 clean rooms, and equipment to provide processing redundancy, as well as fully equipped space for research and surgical training.
This center and others that are to be built or expanded in KeraLink’s six other U.S. sites are essential to its ongoing commitment to serving local academic institutions and private ophthalmologists, Furlong said.
KeraLink has also been investing heavily in surgeon services and has hired and trained additional staff to track tissue within its system and throughout its network of additional cooperating independent eye banks.
“I’m proud to report that more than 97% of the time we’re telling our surgeons that we have their tissue available at least 3 days before their surgery,” Furlong said. Most days we’re at 100%.
“That is of critical importance to our surgeons, and it’s a direct result of the investments we’ve been making in the past year,” he said. “They know they can rely on KeraLink to provide them exactly the tissue they need, when they need it, processed to their specifications.”
Research and training
Research and training have also received a boost. For example, KeraLink is supplying the corneal tissue for a phase I/II investigation of corneal collagen crosslinking using a UV light source on a donor cornea that will serve as a carrier for a keratoprosthesis.
“We’re doing this because the patients who need this procedure are at risk of losing their eye,” Furlong said. “We want to be the place their ophthalmologists turn to obtain the tissue required to save their sight.”
In line with its role as an international organization, KeraLink has launched a program in Bangladesh, where an estimated 500,000 people are waiting for corneal transplants.
KeraLink has joined with a Bangladeshi medical volunteer group, called Sandhani, as well as Rotary International and local Rotary clubs to address the gap between the local tissue supply and demand. Hundreds of Sandhani medical students have volunteered to be trained to obtain consents and recover corneas. This will result in a substantial increase in the number of procedures that can be performed in Bangladesh using locally sourced tissue, from about 60 per year to several thousand each year, Furlong said.
Esen K. Akpek, MD, is familiar with both KeraLink’s national and international programs and sees several benefits from the rebranding.
“Now that KeraLink doesn’t have to worry about the musculoskeletal division, they have more time and resources to dedicate to surgeons and they’re able to listen to what the surgeons need,” said Dr. Akpek, national medical director for KeraLink and professor of ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore.
This focus has been shown through streamlined location and delivery of tissue, as well as stronger emphasis on educational programs being offered at major ophthalmology meetings, at KeraLink facilities, and in collaboration with medical centers.
A joint effort with the Wilmer Eye Institute’s Center of Excellence for Ophthalmic Surgical Education and Training has led to a new CME course on Descemet’s membrane endothelial keratoplasty (DMEK).
By teaching surgeons about new instrumentation and techniques, the course will make it easier for them to convert to a procedure that, while more challenging than Descemet’s stripping endothelial keratoplasty (DSEK), has better outcomes, Dr. Akpek said.
One KeraLink program that she sees as being particularly exciting is increasing the use of irradiated corneal tissue to treat anterior corneal problems, which make up about two-thirds of corneal transplantations performed outside of the United States.
Irradiated corneas, which have a 2-year shelf life, could potentially save the sight of thousands of people, and KeraLink is in discussions for collaborations with eye banks in India and elsewhere to make this tissue available to those who need it the most.