Purpose With the increasing demand for corneas, eye banks must optimize and extend their sources of tissue donation. On the other hand, corneal transplantation is a specialized procedure performed in hospitals with high quality standards and ideally an integrated eye bank. In this report we would like to focus on an international win-win-win agreement between the Department of Ophthalmology at Saarland University Medical Center (Homburg/Saar, Germany), the LIONS Eye Bank Saar-Lor-Lux, Trier/Westpfalz and the four major non-university hospitals without corneal transplantation competence in Luxembourg.

Methods In 2012, at the initiative of the Luxembourgish Ministry of Health and Department of Ophthalmology (Homburg/Saar, Germany), an international agreement was established with the Centre Hospitalier du Luxembourg (Luxembourg). Administrative and legislative rules were developed. Luxembourgish nursing personnel attended a practical training program for corneal excision at the Department of Ophthalmology in Homburg/Saar allowing them to harvest the two first corneal donors on site by themselves during the first year. In the following years two more hospitals, the Centre Hospitalier Emile Mayrisch (Esch-sur-Alzette, Luxembourg) and the Hôpitaux Robert Schuman (Kirchberg, Luxembourg), joined the cooperation.

Results From 2012 until 2021, three hospitals in Luxembourg donated 779 corneas to the LIONS Eye Bank of the Saarland University Medical Center in Homburg/Saar (Germany). In return, 308 Luxembourgish patients have received a corneal transplantation at the Department of Ophthalmology in Homburg/Saar. In 2022, the extension continued and an agreement with a fourth hospital in Luxembourg at the Centre Hospitalier du Nord (Ettelbruck, Luxembourg) was signed providing even more donations.

Conclusion The cross-border collaboration for corneal donation and patient treatment has proven to be successful with both numbers of harvested donors and transplanted patients rising. However, international legislation for tissue donation needs to be accurately respected and a quality management system established to provide continuous quality of the donor tissue.