• Users Online: 38451
  • Home
  • Print this page
  • Email this page

   Table of Contents      
LETTER TO THE EDITOR
Year : 2020  |  Volume : 68  |  Issue : 6  |  Page : 1215-1216

COVID-19 and eye banking


1 Cornea and Anterior Segment Services, L V Prasad Eye Institute, Hyderabad, Telangana, India
2 Cornea, Cataract and Refractive Surgery Services, Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
3 Cornea and Anterior Segment Services, L V Prasad Eye Institute, Bhubaneswar, Odisha, India

Date of Web Publication25-May-2020

Correspondence Address:
Sujata Das
Cornea & Anterior Segment Services, L V Prasad Eye Institute, Bhubaneswar, Odisha
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1033_20

Rights and Permissions

How to cite this article:
Chaurasia S, Sharma N, Das S. COVID-19 and eye banking. Indian J Ophthalmol 2020;68:1215-6

How to cite this URL:
Chaurasia S, Sharma N, Das S. COVID-19 and eye banking. Indian J Ophthalmol [serial online] 2020 [cited 2024 Mar 28];68:1215-6. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?2020/68/6/1215/284756



Coronavirus disease (COVID-19) has rapidly emerged as a global health threat. The virus was officially named as “severe acute respiratory syndrome coronavirus 2” (SARS-Cov-2).[1] According to the Centers for Disease Control and Prevention (CDC), the incubation period of COVID-19 falls within 2–14 days.[2] The incubation period can be as long as 24 days. Symptoms of the infection include fever, cough, fatigue, breathlessness, loss of sense of smell, and diarrhea. Conjunctivitis has also been reported in a small proportion of patients.[3] The disease-causing viral agent is highly contagious and believed to be transmitted through respiratory droplets and/or contact with an infected person. Transmission via ocular surface has also been reported.[3]

Various infection control measures have been evolved in the last few months to minimize the spread of infection to both patients and health care workers. Hospitals have adopted a triage system to minimize cross-infection. Elective surgeries in all specialties, including ophthalmology, have been suspended since the last week of March 2020. Guidelines are evolving regarding protective measures to be adopted by doctors and paramedics. There are specific guidelines for ophthalmologists while examining patients in slit-lamp. Eye Banking is an integral component of eye care services. The present times brought in several deviations from the existing eye bank practices. The eye banking activities would need strategic planning for the future when the situation normalizes. The pandemic has made the eye bankers reflect and introspect crisis that can occur and help devise a plan to handle a similar situation if it arises in the future.

The functions of the eye bank comprise collection (harvesting), evaluation, preservation, and distribution of corneal tissue. The donor cornea is harvested by trained eye bank technicians, ophthalmologists, and general practitioners in a variety of settings like home, ward, and mortuary. Donor cornea, however, carries the unknown and unquantifiable risk of transmission of disease to the recipient that falls into three main categories: infections, neoplasms, and corneal disorders. The contraindication list for eye bank is relatively well laid down, with slight variations globally. The list of contraindications is divided into relative and absolute. Harvesting eyes from donors with conditions potentially hazardous to eye bank personnel should be strictly avoided. Therefore, death due to COVID-19 will fall into this category. The second category of contraindication includes conditions with the potential risk of transmission of local or systemic communicable disease from donor to recipient. Since there is a risk of transmission via ocular surface, it carries a risk of transmission to the recipient. It is too early to have evidence that SARS-CoV-2 can be transmitted by blood transfusion or tissue transplantation. While deaths due to proven COVID-19 can be avoided, without a doubt, the challenge remains how we screen death due to other causes, where there might be a subclinical infection or undiagnosed cases of fever and pneumonia. Maybe a rapid screening test for all donors can help to rule out in the future.

The harvesting can be planned after following a triage system that is used in clinics.[4] The detailed history may be elicited from family members before collection. The collection can be restricted only to the death cases due to completely nonrelated causes like a road traffic accident, hanging, poisoning, etc., Those on ventilators of any time duration should be avoided. Postmortem is performed for all of the above cases. The protocol followed in mortuary needs close vigilance, especially during such pandemic.

The clinical and serological evaluation may not carry specific risks as long as persons handling tissues use general precautions like other health care workers in a hospital setting. It is not worth taking the risk to place counselors in various hospitals during the pandemic period if tissue is not going to be utilized. Since elective surgeries are suspended during the pandemic, the collected tissues may be wasted. We may consider the use of preservative media like Cornisol, where tissue can be preserved for 10–14 days if it is collected from voluntary cases.

Although elective surgeries like optical keratoplasty can be postponed, there is a need for emergency therapeutic and tectonic keratoplasty. In India, the most frequent indications of corneal transplantation are infection.[5] Currently, most of the eye banks in India have discontinued collection through the Hospital Corneal Retrieval Program, which is a major source of cornea collection. The challenge is to manage large perforation and/or large infiltrate, especially one-eyed patients, in an emergency. We have to fall back on alternative procedures like glycerin-preserved cornea, tissue adhesive (small perforation), conjunctival hood, complete tarsorrhaphy, etc., for tectonic purposes as an interim measure of managing the globe threatening conditions. Although we do not have surplus optical quality tissue, we can plan to preserve tissues either in glycerol or gamma irradiation, which have been discarded due to causes other than seropositive reasons.

In view of the prevailing uncertainties related to a state of normalcy, when eye banking activities can be restored to original times, there is also a need to establish guidelines on ways to restart eye banking activities in the future. Each eye bank has to come up with a plan that works in a specific geographical location keeping a track of the updates on the stage of spread of the COVID-19 disease in the area of operation of the eye bank. Stringent safety measures need to be adopted by the eye bank technicians that would include personal protection equipment during donor cornea retrieval. The eye banking activities should be initiated in a calibrated manner in those areas where no cases of active infection are reported.

With the addition of new disease, the list of contraindications gets added up. Therefore, it should be a dynamic document. The decrease in the collection will increase the burden of the preexisting gap of demand-supply of corneal tissue. This pandemic is an opportunity to brainstorm innovative newer methods for long-term storage of corneal tissue, especially for an emergency like this in the future.



 
  References Top

1.
COVID-19: European Centre for Disease Prevention and Control. Available from: https://www.ecdc.europa.e u/en/covid-19-pandemic. [Last accessed on 2020 Apr 13].  Back to cited text no. 1
    
2.
Coronavirus Disease 2019 (COVID-19): Symptoms of Coronavirus. Centre for Disease Control and Prevention (CDC). Available from: https://www.cdc.gov/coron avirus/2019-ncov/sympt oms-testing/symp toms.html. [Last accessed on 2020 Apr 13].  Back to cited text no. 2
    
3.
Lu CW, Liu XF, Jia ZF. 2019-nCoV transmission through the ocular surface must not be ignored. Lancet 2020;395:e39.  Back to cited text no. 3
    
4.
Lai THT, Tang EWH, Chau SKY, Fung KSC, Li KKW. Stepping up infection control measures in ophthalmology during the novel coronavirus outbreak: An experience from Hong Kong. Graefes Arch Clin Exp Ophthalmol 2020;258:1049-55.  Back to cited text no. 4
    
5.
Sharma N, Arora T, Singhal D, Maharana PK, Garg P, Nagpal R, et al. Procurement, storage and utilization trends of eye banks in India. Indian J Ophthalmol 2019;67:1056-9.  Back to cited text no. 5
[PUBMED]  [Full text]  



This article has been cited by
1 Recent advances in small incision lenticule extraction (SMILE)-derived refractive lenticule preservation and clinical reuse
Xiaojun Hu, Ruoyan Wei, Chang Liu, Yunzhe Wang, Danjuan Yang, Ling Sun, Fei Xia, Shengtao Liu, Meiyan Li, Xingtao Zhou
Engineered Regeneration. 2023;
[Pubmed] | [DOI]
2 Donor related corneal graft infection: a review of literature and preventive strategies
Ketan Deogaonkar, Aravind Roy
Seminars in Ophthalmology. 2023; 38(3): 219
[Pubmed] | [DOI]
3 Evolution of eye banking in India – A review
Josephine S Christy, Anand Hari Bhadari, Priya Mathews, Muthiah Srinivasan, Murugesan Vanathi
Indian Journal of Ophthalmology. 2023; 71(9): 3132
[Pubmed] | [DOI]
4 Evaluation of the Clinical Findings of Patients with Penetrating Keratoplasty Followed by Telephone Due to the COVID-19 Pandemic
Semir Yarimada, Özlem Barut Selver, Melis Palamar
Turkish Journal of Ophthalmology. 2022; 52(2): 86
[Pubmed] | [DOI]
5 A Review of Corneal Transplantation: An Insight on the Overall Global Post-COVID-19 Impact
Jay Thakkar, Sandhya Jeria, Aditi Thakkar
Cureus. 2022;
[Pubmed] | [DOI]
6 Bioengineered corneal tissue for minimally invasive vision restoration in advanced keratoconus in two clinical cohorts
Mehrdad Rafat, Mahmoud Jabbarvand, Namrata Sharma, Maria Xeroudaki, Shideh Tabe, Raha Omrani, Muthukumar Thangavelu, Anthony Mukwaya, Per Fagerholm, Anton Lennikov, Farshad Askarizadeh, Neil Lagali
Nature Biotechnology. 2022;
[Pubmed] | [DOI]
7 Challenges in management of microbial keratitis during COVID-19 pandemic related lockdown: a comparative analysis with pre pandemic data
Aravind Roy, Minal Kanhere, Mugundhan Rajarajan, Rohit Dureja, Bhupesh Bagga, Sujata Das, Savitri Sharma, Ashik Mohammed, Merle Fernandes
International Ophthalmology. 2022;
[Pubmed] | [DOI]
8 Clinical Utility of COVID-19 Real Time-Polymerase Chain Reaction Testing of Ocular Tissues of Non–COVID-19 Cornea Donors Deemed Suitable for Corneal Retrieval and Transplantation
Sunita Chaurasia, Dhanwini Rudraprasad, Jalandhar Reddy Senagari, Sunitha Linga Reddy, Srinivas Kandhibanda, Ashik Mohamed, Sayan Basu, Prashant Garg, Joveeta Joseph
Cornea. 2022; 41(2): 238
[Pubmed] | [DOI]
9 Analysis of SARS-CoV-2 in Corneal Tissue of Deceased Asymptomatic Novel Coronavirus Disease 2019 Donors
Karthikeyan Mahalingam, Dewang Angmo, Aanchal Kakkar, Rahul Kumar Bafna, Tushar Sharma, Aishwarya Rai, Sahil Agrawal, Lalit Dar, Rohit Saxena, Jeewan S. Titiyal, Namrata Sharma
Cornea. 2022; Publish Ah
[Pubmed] | [DOI]
10 Effect of Covid-19 on Eye Banks and Corneal Transplantations: Current Perspectives
Francesco Aiello, Gabriele Gallo Afflitto, Giulio Pocobelli, Diego Ponzin, Carlo Nucci
Clinical Ophthalmology. 2022; Volume 16: 4345
[Pubmed] | [DOI]
11 Impacto da pandemia da COVID-19 sobre transplantes de córnea
Carlos Eduardo Ximenes da Cunha, Santília Tavares de Castro e Silva, Marina Viegas Moura Rezende Ribeiro, Fabiano Timbó Barbosa
Revista Brasileira de Oftalmologia. 2022; 81
[Pubmed] | [DOI]
12 Corneal transplantation during COVID-19 pandemic: need for special considerations—A live review
Anuj Kumar Pandey, Nidhi Mudgil, Yogesh Wadgave, Sidharth Sekhar Mishra
AIMS Public Health. 2021; 8(2): 186
[Pubmed] | [DOI]
13 Awareness Regarding Eye Donation and Effects of COVID-19 on Its Perception: A Community-Based Cross-Sectional Study From India
Shibaji Gupta, Saikat Bhattacharya, Seshadri Kole, Debjani Guchhait, Sharmistha Sinha Gupta
Experimental and Clinical Transplantation. 2021; 19(7): 717
[Pubmed] | [DOI]
14 Corneal transplant during COVID-19 pandemic: the Italian Eye Bank national report
Francesco Aiello, Federico Genzano Besso, Giulio Pocobelli, Gabriele Gallo Afflitto, Rossella Anna Maria Colabelli Gisoldi, Carlo Nucci, Diego Ponzin, Paola Bonci, Giuseppe Calabrň, Roberto Ceccuzzi, Massimiliano Corneli, Germano Genitti, Claudio Giannarini, Raffaela Mistň, Augusto Pocobelli, Achille Tortori, Davide Venzano
Cell and Tissue Banking. 2021; 22(4): 697
[Pubmed] | [DOI]
15 Impact of COVID-19 Pandemic on Infectious Keratitis Outcomes: A Retrospective Multicenter Study in Tertiary Eye Hospitals of South India
Josephine S. Christy, Priya Mathews, Anita Rhagavan, Anitha Venugopal, Divya Manohar, Anuja Janakiraman, Preethika Gandhi, Srujana Nallobolu, Esen K. Akpek
Cornea. 2021; 40(11): 1474
[Pubmed] | [DOI]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
References

 Article Access Statistics
    Viewed2906    
    Printed45    
    Emailed0    
    PDF Downloaded457    
    Comments [Add]    
    Cited by others 15    

Recommend this journal