Miracles In Sight aims to end curable blindness

At Miracles In Sight, a nonprofit eye bank that recovers, processes, and distributes ocular tissue, our goal is to bring vision and hope to the world. We recover tissue from about 6,000 eyes each year, about 70% of which are transplanted. The tissue that doesn’t meet quality standards is used for surgical training or research at academic institutions. Our tissue preparation services cover all types of cornea surgery. What’s more, because the supply of corneal tissue in the United States exceeds demand, we distribute tissue internationally and continually find new ways to help the blind.

Future innovations revolve around the three core components of health care’s so-called iron triangle: cost, quality, and access. As we continue to develop our service offerings around these ideals, several fertile areas for innovation have emerged.

Making Key Connections

Miracles In Sight responds to notifications by the central organ procurement organization that someone has died and may be a candidate for donation. We discuss this option with families during a very difficult time in their lives, just hours after they have lost a loved one. Often, the death is unexpected and the donor may be relatively young. Ultimately, we want to gain consent and move forward with recovery, but we know firsthand that the decision to donate — while very generous and profound — is also extremely difficult, especially when it’s made at such a painful time.

Our goal as an organization is to continually strengthen our bonds with donors and families, recognizing their enormous generosity and, ultimately, helping them derive some meaning from a devastating loss. We let families know that thanks to their generosity, a blind person may regain his or her vision in a few days. Donor families are sent a thank you letter and a blanket as a token of appreciation.

Through community outreach, we strive to educate our local population about the benefits of donation with the goal of generating an open discussion. We encourage people to talk to their families about their desire to donate, so that if their family members are faced with an unexpected tragedy, they’re prepared to make the decision based on knowledge of their loved one’s wishes. This informed decision allows us to recover tissue more quickly, which can lead to better surgical outcomes.

Geographic Expansion

Sharing the surplus of corneal tissue recovered in the U.S. with patients around the world isn’t simply a matter of shipping the tissue. Miracles In Sight needs on-the-ground partners and networks. We have strong partnerships with hospitals in Europe, Asia, and the Middle East, and we helped to start an eye bank in India, where we provide training to help doctors there create a more sustainable global infrastructure for donation, processing, and distribution.

In addition to sharing tissue across borders, we can also help fight blindness by sharing knowledge. One recent success was a collaboration between Miracles In Sight, surgeons at Duke University, and Agarwal Eye Hospital in Chennai, India. Surgeons and eye bank staff connected via Skype and site visits to India. This ultimately led to some of the first eye bank-prepared pre-Descemet’s endothelial keratoplasty (PDEK) tissue transplanted in the U.S. This achievement helped bring a new, extremely difficult preparation technique into the eye bank, a technique that had previously been accomplished only by a handful of surgeons in the OR. Since May 2017, Miracles In Sight has prepared more than 10 PDEK grafts for patients at Duke.

Preparation and Storage

Corneal transplants have about an 86% success rate,¹ but we want to do everything we can to increase that percentage. One way is by developing innovative methods of preparation and storage — efforts that also meet the goal of reducing costs.

We’re constantly monitoring trends in ophthalmic surgery. When we identify an area where we may be able to help, we move quickly to develop and provide new services. For instance, part of our preparation process now includes pre-loading the prepared grafts, which saves money in three ways. First, it saves surgeons about 10 minutes per case. It also means they don’t need trephines and disposable injection devices in the OR. Finally, preloaded injectors remove the financial risk of preparing and loading the graft, when the tissue can be damaged, costing the doctor money and requiring the patient to reschedule surgery.

Stakeholder Partnerships

A great deal of Miracles In Sight’s work relies on input from people who are stakeholders from beginning to end, from donor families to nursing staff to ASC billing offices.

We are deeply committed to engaging all of our stakeholders and soliciting feedback so we can improve and adapt to meet all of the challenges and changes they face. That might mean finding new and creative solutions to improve our recovery process or working with accounting teams to ensure the ASC is being properly reimbursed for performing transplant procedures on patients with a unique insurance status in an evolving financial healthcare landscape.

Ultimately, our commitment to these relationships enables us to make a bigger impact, expanding our mission to as many individuals as possible living with curable blindness. The dream is to provide the highest-quality tissue at the lowest cost to everyone in the world, and approaching relationships with that mindset and creativity is bringing us closer to realizing the dream. ■

Reference

1. Cornea Donor Study Investigator Group, gal RL, Dontchev M, Beck RW, Mannis MJ, Holland EJ, et al. The effect of donor age on corneal transplantation outcome results of the cornea donor study. Ophthalmology. 2008;115(4):620-626.