TELEMEDICINE IN THE MODERN EYE BANK Eric Abdullayev MD, MBA,CEBT International Sight Restoration Eye Bank (ISR), Tampa FL, USA Author Has No Financial.

TELEMEDICINE IN THE MODERN EYE BANKEric Abdullayev MD, MBA,CEBT

International Sight Restoration Eye Bank (ISR), Tampa FL, USA

Author Has No Financial Interest To Disclose

Purpose: To introduce a method of telemedicine for performing corneal biomicroscopy (specular, new back light), OCT in the eye bank from remote locations

Methods: Modern computer technology and telecommunications utilized in creating live video and captured still images for immediate corneal microscopic review and OCT from location in Central Asia. 16 human donor corneas located in the US eye bank were evaluated by standard specular , new backlight microscopy and OCT. New Back light microscopy enhanced evaluation by creating real time color corneal images and artificial “Red Reflex”. New digital ruler and digital corneal buttons were used for remote measurements. The same corneas were reviewed for comparing results after evaluator return into the US.

How it works

ISR Eye Bank, Tampa FL

Remote location2. Log-in into HIGH SPEED INTERNET-REMOTE

DESKTOP PROGRAM-WEBCAM–allow : a) secure video session to occur in real time

b) to see each other and talk,

c) to access computer on other side at any time

1. DONOR CORNEAS EVALUATION In the Eye Bank– live video or still corneal images

taken, processed and stored in database

4. The remote colleague reviews live evaluation or reviews and evaluates corneal

images stored in the eye bank computer, gives instant recommendations or updates evaluation

results in the eye bank database.

3. The remote colleague logs in from his computer or I-Pad

Remote Location

Back Light Microscopy (Direct) - Epithelial Sloughing

25x25x

40x 25x

Back Light Microscopy - Artificial “Red Reflex”

Surgical scars Evaluation

x25

x25

x40

Back Light Microscopy Distant or Artificial “Red Reflex”

40X

25X

25X

25X

Specular Microscopy

Normal endotheliuml

Stress striae

Cells loss

Results: 16 donor corneas were evaluated remotely. All corneal layers were reviewed. Artificial “Red Reflex” enhanced remote ability for evaluation of the stromal opacities and Descemet’s folds. Stromal infiltrate was suspected in 1 cornea. Digital ruler and digital corneal buttons were effective in measurement of clear zones, scleral rims and other parameters. Specular microscopy, cells density calculation and live performance review performed without observed difficulties. The same 16 corneas were reviewed by same specialist after his return to US. No differences were found. Stromal infiltrate confirmed in 1 cornea. OCT was effective in evaluation of the tissue prepared for endothelial keratoplasty.

Conclusion: Telemedicine expands capability of the modern eye bank specialists to remotely perform corneal biomicroscopy and OCT. It opens opportunity for domestic and international consulting and training.

Thank you !!!

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