Immediate impact of COVID-19 on eye banking in India

Abstract

Purpose: In India, COVID-19 infected more than 10 million and caused more than 148,000 fatalities during 2020. Due to “lockdown” eye banks were shuttered in March, 2020 and reopened for operations in the month of May, 2020. This study assesses the immediate impact of the pandemic on eye banking and cornea transplantation in India. Methods: Data was gathered through an online survey of the eye banks and cornea surgeons in India. The questionnaire collected information on the vital statistics of eye bank operations and cornea transplants for the period from March to June for the years 2019 and 2020. Results: 47 eye banks responded to the survey. Collectively in the March–May 2020 period, corneas collected and transplanted declined by 78.27% and 79.14%, respectively, compared to the same period of 2019. In June 2020, the first full month after operations restarted, the collection and transplants were respectively, 82.10% and 81.82%, lower than June, 2019. Long-term glycerine preservation of corneas in the period from March to June 2020 increased by 124.5% compared to same period in 2019, but overall only 5.26% of the corneas recovered were preserved in this way. 44.44% of the eye banks collected corneas only from donors with negative COVID-19 diagnosis. 36.11% of the respondents rejected all suspicious cases, such as donors with respiratory pathologies, and 2.78% of the respondents accepted donations from medico legal cases only. 19.44% of the responding eye banks did SARS-CoV-2 nasal swab test for the deceased donor. 79.5% of the eye banks reported that staff were willing to work during the pandemic, and 82.05% eye banks gave special training to staff before restarting services. Conclusion: Due to the steep decline in collections and transplants, 2020 can be termed as a lost year in Indian eye banking. Attention to Hospital Cornea Recovery Programs, continuous situation monitoring, and ongoing staff training programs are recommended.

Global impact of COVID-19 on corneal donor tissue harvesting and corneal transplantation

“…In their survey, the least stringent criteria mandated a 14-day symptom-free period before death, whereas the most stringent criteria mandated a period double that time. Moreover, they reported that the definition of COVID-19 symptoms varied among different exclusion guidelines, with the strictest criteria mandating exclusion of those with “unexplained cough, unexplained asthenia and myalgia, intermittent fever, shortness of breath or unexplained conjunctivitis before death.” Such variability in screening criteria was also observed in a survey of Indian eye banks ( 17 ), which reported that a fraction of the eye banks avoided tissue retrieval from COVID-19 positive cases (44.4%) or those with suspicious respiratory symptoms (36.7%). In contrast, some eye banks (16.67%) completely halted tissue collection.…”

“…Due to an increase in the number of wasted donor tissues, Busin et al ( 27 ) underlined the importance of exploring alternative procurement techniques that would extend the storage time of procured corneal tissues and reported tissue dehydration as a useful alternative method, especially in the case of deep anterior lamellar keratoplasties. A survey of eye banks and surgeons in India showed a statistically significant increase in the use of long-term tissue preservation methods in the same period in 2020 compared to previous years ( 17 ).…”

Evolution of eye banking in India – A review

“…In addition, COVID also saw an increase of 125.4% in the use of glycerin-preserved corneal tissues, which had reliable therapeutic outcomes. [ 44 ] The pool of eligible donors decreased because patients who had COVID or were suspected positive at the time of death were not eligible for organ donation, despite the lack of evidence demonstrating possible transmission of COVID-19 through corneal transplantation. For organ procurement, the handling and harvesting procedures changed.…”

Eye banking and keratoplasty trend analysis during the COVID-19 pandemic: A South Indian observational study

“…The total number of eye donations in the pre-COVID-19 era was 50,953, which drastically reduced to 18,359: a 63% decline. [ 3 ] Similarly, total corneal transplantation in 2019 was 27,075, which came down to 12,998: a 52% drop. Das et al .…”