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

Purpose: To analyze the impact on eye donation and corneal transplantation during the COVID-19 pandemic in a tertiary eye hospital in south India. Methods: A retrospective analysis of the donor and recipient records during the study period from January 2020 to May 2021 was conducted and tabulated in Microsoft Excel 2013. Demographic details of the donor, utility rate, cause of death, culture characteristics, storage methods, wet lab usage, and the surgical donor outcomes were evaluated. Additionally, the postoperative workup of the recipients, diagnosis, graft infection and rejection episodes, development of COVID-19 postoperatively, and outcome in terms of visual acuity at one, three, and six months were also noted. Results: A total of 466 eyes from 249 donors were received during the study period. The mean age of the donor population was 62.43 years (20.9). The corneal transplantation utility rate was 36.4% (n = 170). Fifty-one percent of the total transplant surgeries were for therapeutic purposes. This was followed by penetrating optical keratoplasty (34%), Descemet's stripping endothelial keratoplasty (9%), and patch grafts (3%). Seventeen (10%) graft rejection episodes were noted and nine (53%) had complete resolution after medical treatment. Conclusion: Proper preventive measures are key to carrying out safe and efficient eye banking activities even during a deadly pandemic, as COVID-19 transmission via transplantation is rare.

Impact of pandemic COVID-19 lockdown on penetrating keratoplasty patients.

Purpose: To study the impact of the COVID-19 lockdown on the regular follow-up of keratoplasty patients. Methods: This retrospective interventional case series included 30 patients who had immunological corneal endothelial rejection out of 190 patients who came for post-PKP follow-up between September 15, 2019, and September 30, 2020. The demographics, primary diagnosis, surgical technique, time of presentation, recovery of graft, associated ocular problems, and visual acuity at 1 month were analyzed. Forward stepwise (likelihood ratio) binary logistic regression was used to find significant variables. Results: The study population had 19 males (63.33%) and 11 females (36.67%). The mean age of the study group was 42.83 ± 18.89 (8-80) years. Of 30 patients, 19 (63.3%) presented before and 11 (36.7%) after the COVID-19 lockdown. Overall, 23 (77%) showed a reversal of graft rejection. Logistic regression showed that preoperative indications, large-sized grafts, and deep corneal vascularization were significant risk factors for non-resolution of graft rejection. It was noted that patients who presented to the hospital late had poor recovery (P = 0.002). The delay in the presentation was a significant risk factor for non-resolution of graft rejection (P < 0.01). Z-test for proportions revealed that the difference in the non-resolution of rejection on immediate or delayed treatment in patients presenting during lockdown (P = 0.002) was significant. Conclusion: This article is to highlight the impact of the COVID-19 lockdown on graft rejection recovery of PKP patients due to delays in follow-up. Early treatment helps in the recovery of graft transparency and the reversal of immunological graft rejection. Also, primary diagnosis, deep vascularization, and large-sized grafts were significant risk factors for non-resolution of graft rejection.

Impact of COVID-19 related national lockdown on care of corneal transplantation patients at a tertiary eye care centre in India.

PURPOSE: To study impact of COVID-19 related national lockdown on care of corneal transplantation patients at a tertiary eye centre in Andhra Pradesh state of South India. METHODS: Cross-sectional questionnaire-based study conducted at tertiary eye care centre in Andhra Pradesh state of South India, included 109 patients who underwent keratoplasty(full thickness or partial thickness) at our centre and who came for follow-up visit after lockdown. Factors such as type, indication, number of keratoplasties in the operated eye, and unusual clinical outcomes identified during visit after the lockdown, were studied. Uncorrected visual acuity, best corrected visual acuity, clarity of graft, graft-host junction apposition, intactness of sutures, intraocular pressure and disc status were compared on visits made before and after lockdown. RESULTS: During lockdown, 77.1% patients were properly using medications that was significantly (P = 0.0003) lower than that of before the lockdown (90.8%). After the lockdown, 82.3% patients were using medications properly that was comparable (P = 0.11) to that of during the lockdown (77.1%). The proportion of eyes with clear grafts and intact sutures decreased significantly after lockdown. The unusual outcomes observed after the lockdown were graft failure (36.7%), graft edema (11%), graft infiltrate(5.5%), phthysis bulbi (1.85%) and edematous graft cleared in eyes 3.7% eyes. CONCLUSION: We noted significant drop in usage of medications from 91% before lockdown to 77% during lockdown and maintained at 83% after lockdown. Edematous grafts increased from 41% before lockdown to 54% after the lockdown. Intactness of sutures decreased from 82% before lockdown to 69% after lockdown.

Impact of nationwide COVID-19 lockdown on keratoplasty and eye banking in India: A survey of cornea surgeons and eye banks.

PURPOSE: The aim of this study was to analyze the impact of COVID-19 lockdown on keratoplasty and Eye Banking in India. METHODS: An e-mail survey was conducted among cornea surgeons and eye bankers of India. Participants were asked to report their practice patterns for the management of corneal perforation during lockdown, different preservative media used during and before lockdown, and waiting time and waiting time before COVID-19 lockdown. RESULTS: Eight of 20 eye banks did not collect corneal tissue during April-June 2020; in contrast, 9 eye banks used to collect around 100 corneas per month during pre-COVID-19 time. Two-third of the surgeons (66.1%, n = 41/62) did not perform any corneal tissue transplant between April and June 2020. Cyanoacrylate tissue adhesive application was the most commonly, performed procedure (79%, n = 49/62) for tectonic purpose during this period. Glycerol was the most preferred alternative preservation method considered by both the groups. More than half of the surgeons (64.5%, n = 40/62) had an average waiting time of <1 week for scheduling patients for keratoplasty in pre-COVID-19 period. CONCLUSION: There is was a significant drop in both corneal tissue retrieval and utilization during during COVID-19 lockdown. There was a felt need for an alternate long term storage media.

Ocular surface manifestation of COVID-19 and tear film analysis.

To evaluate the ocular manifestation in patients hospitalized with coronavirus disease 2019 (COVID-19) and to search for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in tears. This study was conducted in 29 hospitalized patients who were admitted to the COVID center at the Policlinic Hospital of the University of Messina, Italy. All patients underwent an ophthalmologic assessment comprising a Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire, anterior segment, and the ocular surface examination of both eyes using a portable slit lamp. The Schirmer I test was performed, and the filter paper strip was used to search for the presence of SARS-CoV-2 on the ocular surface by real-time quantitative polymerase chain reaction (RT-qPCR). A total of 10 patients reported ocular symptoms; in particular, four reported eye burning, three reported foreign body sensation, and three reported tearing. Moreover, seven patients presented conjunctival hyperemia and/or chemosis, eleven patients presented blepharitis signs such as lid margin hyperemia and/or telangiectasia, crusted eyelashes, and meibomian orifices alterations. Tear analysis did not reveal the presence of SARS-CoV-2. Ocular symptoms are common in patients with COVID-19; although, tear analysis did not reveal the presence of SARS-CoV-2.