•Different recovery procedures, storage techniques, and in more recent years, tissue processing techniques, have been introduced and each have their own benefits and risks in regard to their technical, microbiological and tissue evaluation aspects.

•Eye bank preparation of donor tissue for lamellar endothelial keratoplasty procedures is evolving rapidly but presents unique challenges to the eye bank, especially in regard to handling and iatrogenic damage during processing.

Introduction

The foundations of eye banking and corneal preservation were laid by Filatov in 1937 with the recognition that donor tissue for corneal transplants could be recovered post-mortem [1]. For many years, the ophthalmic surgeon was in direct control of the process, often being directly responsible for both procurement of donor tissue and the transplant surgery itself. However, over the past few decades, the responsibility for the provision of a viable, disease-free donor cornea has been entrusted to the eye bank, and the ophthalmic surgeons now have to rely on these services as an important aspect of their surgery and treatment.

The first eye bank was perhaps the Eye Bank for Sight Restoration in New York, founded in 1944. At this time, eye banks functioned as collection centres and simple storage facilities, holding whole globes in moist pot storage prior to corneal transplantation, which was usually undertaken within 24 h of donor eye retrieval. Eye banking practices expanded during the 1970s with the development of corneoscleral storage solutions [2] which allowed, for several days, storage and the refinement of corneal evaluation procedures to determine the suitability and likely efficacy of a cornea for a particular transplant procedure. Such activity helped support the rapid growth of corneal transplantation over the same period which was being driven by advances in instrumentation, surgical microscopy and suture development. Accompanying such growth was the appreciation that corneal transplantation could potentially transmit a number of diseases from donor to recipient, and eye banks became increasingly responsible for donor screening for such diseases [3]. Many of the standards to assist in these practices were initially developed by the Eye Bank Association of America (EBAA, www.restoresight.org) who produced their first set of Medical Standards in 1980. These standards are maintained and updated by rigorous and regular review processes. Other Eye Banks and Eye Banking associations, such as the European Eye Bank Association (EEBA, www.europeaneyebanks. com) and the Eye Bank Association of Australian and New Zealand (EBAANZ, www.ebaanz.org) have also developed their own set of Standards using those of the EBAA as their basis and cover areas such as donor selection and testing, personnel and training, facilities and equipment, documentation, procurement and corneal preservation.