Corneal transplant during COVID-19 pandemic: the Italian Eye Bank national report

Abstract

To investigate the impact of Coronavirus Disease-2019 lockdown on the Italian Eye Bank organization. In this national retrospective, multicentric, cohort study, data from the Italian Eye Bank during both the lockdown and the first month after the lockdown period were retrieved. We compared the Italian Eye Bank metrics with the same timeframe of 2019 and 2018. Data from 13 out of 13 (100%) Italian Eye Banks were included in the analysis. A statistically significant reduction in the number of donor corneas retrieved in 2020 was found as compared to the same period in 2019 and in 2018, respectively (2020 = 1284; 2019 = 3088; 2018 = 3221; ANOVA: p < 0.0001). Only 534 corneas have been distributed by Eye Banks during the COVID-19-lockdown period (2020 = 534; 2019 = 1220; 2018 = 1237. ANOVA: p < 0.0001). Similarly, the number of wasted corneas due to postponed or cancelled surgeries was 421, resulting in a considerable increase as compared to the previous 2 years (2020 = 421; 2019 = 67; 2018 = 84; ANOVA: p = 0.0035). Overall, 45 donor corneas were rejected in accordance with the guidance of the Italian National Health Institute Italian National Transplant Centre (CNT). SARS-CoV-2 pandemic has profoundly affected every social and medical field, including the Eye Bank procurement and distribution programs. The current data collected from all the Italian Eye Banks highlights the present and the forthcoming difficulties that the Eye Bank community is going to experience, as for the ongoing pandemic.

The Impact of COVID-19 on Missed Ophthalmology Clinic Visits

“…This was seen internationally with a decrease in corneal transplants in Italy and a decrease in cataract surgeries in London. 7 , 8 Recognition of the potential for harm from missed visits may have offset the perceived risk of COVID-19 transmission. We were surprised to find that missed visit rates between new and returning patients were remarkably similar.…”

“… 1 Around the world, ophthalmologists have reported a 56% drop in cornea transplants in Italy and cataract surgeries were postponed for three months at Moorfield’s Eye Hospital. 7 , 8 As the ophthalmology community continues to balance providing care with mitigating risk to patients and providers, it is important to understand possible disproportionate impacts on care for different patient populations. 9 For example, job losses related to COVID-19 and economic turmoil have hindered patients’ access to health insurance and other resources, 10 especially patients of racial and ethnic minorities.…”

Post-Mortem RT-PCR Assay for SARS-CoV-2 RNA in COVID-19 Patients’ Corneal Epithelium, Conjunctival and Nasopharyngeal Swabs

“…Thus, some clinically relevant conclusions may be derived from the aforementioned data. In fact, ophthalmic aerosol-generating procedures (i.e., air puff tonometry, phacoemulsification [ 37 ], pars plana vitrectomy [ 38 ]) may be at high risk of viral transmission [ 39 ]. On the other hand, despite the aforementioned limitations of the study, our results seem to corroborate Bayyoud et al’s conclusions [ 30 ], where they speculated that corneal tissue procurement and processing for corneal transplantation surgery may be a relatively safe procedure due to the absence of viral corneal contamination [ 30 ].…”

Impact of the Coronavirus Disease 2019 Pandemic on the Ophthalmology Department

“…In Korea, previous studies have reported reduced patient visits due to the COVID-19 pandemic. Brant et al described that missed visits to the Ophthalmology Department increased dramatically during the COVID-19 pandemic [ 4 ], and Aiello et al reported that the rate of corneal transplantation was significantly reduced (−56%) compared with that in 2019 in Italy [ 9 ]. In India, during the COVID-19 lockdown, ophthalmologists were not seeing patients, and had near-total cessation of elective surgeries [ 7 ].…”