Banking on KC – Tony Bavuso, CEO of Saving Sight
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Kelly Scanlon:
Welcome to Banking on KC. I'm your host, Kelly Scanlon. Thank you for joining us. With us on this episode is Tony Bavuso, the CEO of Saving Sight, a nonprofit whose mission is to change lives by saving sight. Welcome, Tony.
Tony Bavuso:
Hi, Kelly. Thanks for having me.
Kelly Scanlon:
Saving Sight, has a long history in Missouri. In fact, it just celebrated a milestone anniversary. You go back 60 years to 1960. Give us a little bit of background on how it got started and why.
Tony Bavuso:
Saving Sight started as an eye bank back in 1960, about the same time that Lion's Club members in different states around the country were making a grassroots effort to start eye banking. When many people think about the field of organ and tissue donation, they don't realize that eye banking has been around longer than organ banking has. It took that grassroots effort from Lion's Club members who really took to heart the mission from Helen Keller speaking at one of their international meetings about blindness, and they made that their cause. Helping to get eye banking started at a grassroots level around the country was the origin for not only our eye bank but a lot of other Lion's eye banks around the country. It was done here in Missouri in partnership with the University of Missouri and Columbia. Then over the years, we have grown in our service area to include both Kansas and central Illinois.
Kelly Scanlon:
So a three-state region now.
Tony Bavuso:
Three state region now, and we currently have five offices throughout our territory to serve the individual communities within.
Kelly Scanlon:
More recently, the name was changed to its current name, Saving Sight.
Tony Bavuso:
Yeah. That's been about eight years ago, roughly, now. Our corporate name did not change. Our corporate name is the Missouri Lions Eye Research Foundation. Prior to Saving Sight, we did business under the name Heartland Lions Eye Banks, and then about eight years ago we changed the name to Saving Sight. That name change was really about us being able to encapsulate the work that we do within the name. One of the core functions that we do as an eye bank is we speak to families about eye donation sometimes a few minutes after their loved one has passed away. They didn't know who we were, and it was hard to explain who we were based on our name. That was a practical thing that drove our name change, but also we felt that it better encapsulated who we are and what we do. In that process of rebranding under the name Saving Sight, we updated our mission to reflect the same.
Kelly Scanlon:
In addition to the longer name being a practical concern, when you talk about Saving Sight, when you're talking with the family, that just conveys a sense that their loved one will be doing something positive, that there'll be part of them living on and doing something constructive. Even in their death, they're saving sight.
Tony Bavuso:
Absolutely.
Kelly Scanlon:
It makes so much sense.
Tony Bavuso:
It also reflects a call to action.
Kelly Scanlon:
Yes.
Tony Bavuso:
Just the name itself reflects this call to action for stakeholders and people in the community who hear who we are. Just the name says hey, be part of this mission to change lives by saving sight.
Kelly Scanlon:
Talk to us then about what happens at Saving Sight on a daily basis.
Tony Bavuso:
Sure. Eye banking is part of the larger field of organ and tissue banking, and so we definitely have partners within the industry, so to speak. There is an organ and tissue recovery agency here in Kansas City that we work closely with. There's also one in St. Louis and one in Chicago that we work closely with across our territory. There are also hospitals that we work closely with. There are surgeons that we work closely with, medical examiners, funeral directors. It's a large community of different folks, different stakeholders, that somehow have involvement in the work that we do.
Tony Bavuso:
In terms of a typical day here at Saving Sight, we are a 24/7, 365 operation, so we never are closed. We have agreements with hospitals in our three-state area. Hospitals are required to have these agreements in place with eye, organ and tissue banks, where when someone passes away in the hospital, they refer that death to us. We have a few preliminary questions that we ask to see if the person might be a candidate for eye donation. If they are a candidate, the first thing that we do is check the state registry to see if they said yes to being a donor when they renewed their driver's license, or got online and registered themselves as a donor. If they're not on the registry, then we reach out to their legal next of kin and we go through an informed consent process with their next of kin to obtain consent. We also ask them some questions about their medical and social history as part of our screening process.
Tony Bavuso:
Then we dispatch a technician who's trained to do the actual eye tissue removal onsite, typically at the hospital, sometimes in the morgue. These technicians will do the surgical removal of the cornea, which is the front part of the eye, the clear part that looks a little bit like a contact lens when it's removed, and that gets preserved in a media that allows us to store the tissue onsite here for 14 days under refrigeration. As soon as that tissue is recovered and preserved, we move quickly through a process to do a very thorough review of the donor's medical history and we build out their own medical chart here, our version of the medical chart here, and then that gets reviewed and approved if there is nothing in the medical history that would prevent them from being able to use that tissue for a transplant.
Tony Bavuso:
We also do a microscopic evaluation of the tissue in our laboratory. For some surgeons who are doing newer techniques in corneal transplant surgery, we do some additional processing. Sometimes we do a resection of the tissue, or we do a manual peel of a particular layer, the back layer of the cornea for an endothelial transplant. We have these relationships with surgeons who use our tissue for transplant in their patients. We have a plentiful supply, a plentiful enough supply of eye tissue that corneal surgeons can just call us and schedule a surgery date with their patients, and then we give them a call a few days ahead of that surgery to let them know what tissue we have available. Then we make arrangements and take care of the logistics of getting the tissue from us to the surgery center for transplantation.
Kelly Scanlon:
Yeah. Really, you act as a facilitator of the entire process...
Tony Bavuso:
We do.
Kelly Scanlon:
... from securing the tissue to storing the tissue, to delivering the tissue to the surgeons who need it.
Tony Bavuso:
Yes. In fact, as of a few years ago, you might even hear some surgeons say that it goes beyond that. One surgeon famously said that he relies on his local eye bank to make the first cut in his surgery because of the processing that I mentioned. That's something that has developed out, really, a lot of collaboration and trust between local eye banks and the surgeons that they serve. They have grown to recognize that we have the volume and some really good technicians who do this over and over again every single day, and have developed a really great skill set to do resection, specialized processing, in a really excellent way. It saves the surgeon time and money, and it saves the surgeon from an issue coming up if the tissue gets messed up.
Kelly Scanlon:
You mentioned that you have an abundance of corneal transplants. You have enough, as you said. What is the demand? Not just locally, but nationwide. What is the demand for corneal transplants, and what are some of the leading causes that drive that demand?
Tony Bavuso:
In the United States, the demand for cornea transplants is somewhere around 55 to 60,000 per year. That is relatively stable. It's not growing a whole lot. As the eye banking industry has matured, we have really gotten to the point where we're able to meet the demand here in the United States and then some. What ends up happening is a lot of us eye banks, especially those of us that are larger eye banks in the country, and Saving Sight is probably ranked six or seven in terms of size of eye bank in the United States, a lot of our tissue that isn't needed here in our local area, or in our country, gets sent abroad. They don't have mature local eye banking systems in their countries, and so there is a huge reliance on the United States to provide cornea tissue in other countries that just don't have access.
Kelly Scanlon:
In 2016, you launched Vital Tears. What is that and how does it live within the overall mission of Saving Sight?
Tony Bavuso:
Vital Tears came about as a result of a couple of our corneal surgeons that we work most closely with asking me and us as the eye bank to provide autologous serum eye drops. Vital Tears are typically used by people who suffer from severe dry eye or other related conditions at the surface of their eye that causes inflammation. They receive Vital Tears by visiting their eye doctor, and this could be a corneal surgeon. That's how Vital Tear started is because we work so closely with corneal surgeons. Many of them have chronic dry eye patients that they are treating. Also, we serve optometrists and the patients that they have. There are optometrists out there who are also treating dry eye patients and write orders for autologous serum eye drops for their patients. It's all done online. We have an online system. When an eye doctor wants to prescribe these tears for their patients, they link up with us and we get them in our system and then set their clinic up so that patients who come in and need this can order them as a result of being in the system.
Tony Bavuso:
The reason surgeons were coming to us asking for this is that there is very little access in the community. Some surgeons were having to try to do this on the counter in the back of their clinic. They saw us as equipped; having good facilities and the right quality assurance programs in place to do this in a more consistent and scaled up way. After they asked me over and over again for probably two or three years before I finally listened and decided well, maybe we should try to meet this request, we ultimately did. When we did, we realized just how little access there was to serum tears. Not just in our area here and in our three-state area, but across the country. We really rolled things out slowly to give ourselves time to figure out the most efficient way to provide tears. First here locally, and then beyond our general scale, and then now we're nationwide. That required a lot of infrastructure building and partnering to make that happen.
Kelly Scanlon:
Talk to us about future possibilities. What are some of the coming innovations in corneal transplant surgery that you're excited about?
Tony Bavuso:
Yeah. Corneal transplant surgery has evolved a lot over the years and over my time, 23 years in eye banking. Most cornea transplants were full thickness. If you think of taking a cookie-cutter and punching a circular button out of good donor tissue and punching the same size button out of the patient's diseased cornea and swapping them, that's what a cornea transplant was for many, many years. Those are still done when necessary, but following the trends in other specialties of medicine, corneal transplant surgery has gotten more targeted. There are five layers to your cornea, and now surgeons are transplanting just the layer level of disease. If you are a patient who suffers from a disease that damages the back layer of your cornea, which is a large number of people who receive cornea transplants, about 60% of the tissue we send out is for those kinds of transplants, then the surgeon is really only transplanting the back layer of the cornea. That was a big shift in corneal transplantation over my time.
Kelly Scanlon:
It's just amazing how fine of a process that is, that they can isolate it to just a slender layer like that.
Tony Bavuso:
The thickness of those layers that get transplanted has gotten thinner and thinner and thinner over time to the point now where we're doing a manual dissection of the back layer of the cornea and sending that to surgeons. That's only about 10 or 20 microns thick. It's like wet tissue paper, trying to work with it. Those are being sent out now, and that's quite a leap from where we were when I first started out in eye banking. I think the future will continue in that direction. Some things that are on the horizon would be like injectable cells. Rather than transplant a layer of tissue, it's a certain volume of cells that have a way of attaching themselves to the back of a person's cornea and then taking root, so to speak, and functioning to repair the damage.
Kelly Scanlon:
Oh, wow.
Tony Bavuso:
Yeah. I would say that's still perhaps quite a few years away, but that is something that is being researched right now and worked on. A lot of work's being done in that area.
Kelly Scanlon:
Yeah. That definitely has a lot of interesting implications. One of the beneficiaries of Saving Sight was a well-known Kansas City artist by the name of Gabriella Mountain. She created a number of larger-than-life commissioned sculptures around Kansas City, sculptures, mosaics with some stained glass pieces. One of those was the Old Main Library's floor at 12th and McGee, but tell us about that story because I find that story fascinating because it's just one of those true feel-good stories where the gift came full circle, so tell us about that.
Tony Bavuso:
Sure. Yeah. The gift did come full circle with Gabriella Mountain. She was in need of a cornea transplant, so she received one and the tissue came from Saving Sight. She talked to her surgeon, learned from her surgeon about where the tissue came from, and became interested in the work that we do. Through her surgeon, we made a connection with her and we're able to tell her more about what she was interested in about what we do and how this whole sort of a miracle for her if the sight came to be. As a result of that relationship, she decided that she wanted to contribute more to the work that we do and arranged for Planned Giving to come to Saving Sight as a result of her receiving a cornea transplant. We became the beneficiary of her generous donation to the work that we do.
Kelly Scanlon:
Yeah. That was fairly recently. She passed away at the age of... She was over 100 years old. I think she was 102. Just to piggyback off of that story, there are ways that the community can get involved, our listeners can get involved in what you do. You don't have to be a technician or you don't have to be a transplant surgeon to get involved with Saving Sight. Tell us about some of the ways that the community can work with you.
Tony Bavuso:
The first thing that we always tell people is to advocate. Be an advocate for organ and tissue donation and for eye donation in our case. If you're not on the donor registry in the state of Missouri or the state of Kansas or the state of Illinois to do that, the other thing is to speak to your family about your desire to be a donor, because often times when someone passes away and we end up speaking to the family, they don't know what the wishes of their loved one are or were, and it can make for a difficult decision for family members. I think getting on the registry and then speaking to your family about wanting to be a donor are two really important pieces to the puzzle here.
Kelly Scanlon:
Tony, thank you so much for being our guest today on this episode of Banking on KC. We appreciate all the work that you do for all those needing cornea transplants and wish you lots of luck in the future.
Tony Bavuso:
Thank you, Kelly. It was a pleasure.
Joe Close:
This is Joe Close, president of Country Club Bank. Thank you to Tony Bavuso for being our guests on this episode of Banking on KC. Our ability to see is something most of us take for granted, but for a significant number of people who have lost that ability through injury, accident or disease, receiving a corneal tissue transplant is the key to having their vision restored. Saving Sight's innovative processes and solutions are becoming a global model for how eye banking and sharable vision services can best serve people and communities. Country Club Bank has long been a supporter of giving back to the community. Becoming an organ donor is giving back in the most personal way possible. Donors literally give up themselves. As you consider how you can make a difference, don't overlook organ donation. It's an investment in someone's future. Thanks for tuning in this week. We're banking on you, Kansas City. Country Club Bank, member FDIC.