Casagrande Maria Katharina1,*, Bigdon Eileen1, Mushumba Herbert2, Pueschel Klaus2, Mutesa Leon3, Nyemazi Alex4, Spitzer Martin1
1Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
2Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
3Center for Human Genetics, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda
4Department of Ophthalmology, Rwanda Military Hospital, Kigali, Rwanda
The World Health Organization (WHO) estimates that 33 million people worldwide are currently blind and 191 million live with severely impaired vision. Unfortunately, 90% of these people live in the poorest parts of the world [1, 2].
In 2002, a WHO report mentioned that 5.1% of blindness globally was due to corneal clouding  and that 98% of global corneal blindness occurs in developing countries and affects young people .
In sub-Saharan Africa, the prevalence of blindness is about 7 million and about 30 million have impaired vision . The prevalence of blindness in the 50+ age group in Western and Eastern Sub-Saharan Africa is at 4% compared to 0.4% in Europe .
Potential risk factors of corneal blindness are injuries, infections, corneal dystrophies, keratoconus, onchocerciasis, trachoma, and smallpox infection. Strong prevention measures have been reported to limit corneal blindness. However, in the most affected areas, prevention strategies have often failed or are not in place . Corneal transplants have therefore been used to successfully restore sight.
Other surgical approaches in corneal surgery are also available: These range from penetrating keratoplasty to the exchange of individual layers; the example being Descemet-stripping endothelial keratoplasty (DMEK) . In developing countries, it is estimated that 80-90% of corneal blindness can be treated through perforating keratoplasty and as such, these therapies have therefore yielded good and long-term results for a considerable number of treated patients