Venugopal Kavitha Chikkanayakanahalli, Melsakkare Suresh Ramappa, Manipur Sahana R, Acharya Pavana, Ramamurthy Lakshmi Bomalapura
Professor and Head of Department, Department of Ophthalmology, HIMS , Hassan, Karnataka, India .
Professor and Head of Department, Department of General Medicine, HIMS , Hassan, Karnataka, India .
J Clin Diagn Res. 2015 Aug;9(8):NC05-7. doi: 10.7860/JCDR/2015/14304.6385. Epub 2015 Aug 1.
In developing countries, corneal diseases are the second leading cause of blindness. This corneal blindness can be treated through corneal transplantation. Though the present infrastructure is strong enough to increase keratoplasty numbers at a required rate, India has largest corneal blind population in the world. So a constant supply of high quality donor corneal tissue is the key factor for reduction of prevalence of corneal blindness. Considering the magnitude of corneal blindness and shortage of donor cornea, there is a huge gap in the demand and supply.
To study the potential for hospital based retrieval of donor corneal tissue in Hassan district hospital after analysing the indicated and contraindicated causes of deaths, so that hospital corneal retrieval program in Hassan district hospital can be planned.
The cross-sectional, retrospective and record-based study included all hospital deaths with age group more than two years occurred during one year period (January 2014 to December 2014). Data regarding demographic profile, cause of death, treatment given and presence of any systemic diseases were collected. The causes of deaths which are contraindicated for the retrieval of corneas were analysed and noted. The contraindications were based on the NPCB guidelines for standard of eye banking in India 2009.
Out of 855 deaths, number of deaths in males (565) was greater than females (290). Numbers of deaths were highest between 41-60 years age group (343). Deaths due to HIV, septicaemia, meningitis, encephalitis, disseminated malignancies were contraindicated for corneal retrieval. Corneas could be retrieved from 736 deaths out of 855. Potential for corneal retrieval in a period of one year in Hassan District hospital was 86%.
Hospital corneal retrieval program has got a great potential to bridge the gap between the need for the cornea and actually collected corneas which will contribute enormously in eliminating corneal blindness. In present study there was 86% potential for corneal retrieval among the hospital deaths.
在发展中国家,角膜疾病是导致失明的第二大主要原因。这种角膜性失明可通过角膜移植进行治疗。尽管目前的基础设施足以按所需速度增加角膜移植手术的数量,但印度却是世界上角膜盲人口最多的国家。因此,持续供应高质量的供体角膜组织是降低角膜性失明患病率的关键因素。鉴于角膜性失明的严重程度和供体角膜的短缺,供需之间存在巨大差距。
在分析死亡的适应证和禁忌证后,研究哈桑地区医院基于医院的供体角膜组织获取潜力,以便规划哈桑地区医院的医院角膜获取项目。
这项横断面、回顾性且基于记录的研究纳入了在一年期间(2014年1月至2014年12月)发生的所有年龄超过两岁的医院死亡病例。收集了有关人口统计学特征、死亡原因、所接受治疗以及是否存在任何全身性疾病的数据。对禁忌获取角膜的死亡原因进行了分析并记录。这些禁忌证依据2009年印度国家眼科角膜库标准的NPCB指南。
在855例死亡病例中,男性死亡人数(565例)多于女性(290例)。死亡人数在41 - 60岁年龄组最高(343例)。因艾滋病毒、败血症、脑膜炎、脑炎、播散性恶性肿瘤导致的死亡禁忌获取角膜。855例死亡病例中有736例可获取角膜。哈桑地区医院一年期间角膜获取潜力为86%。
医院角膜获取项目在弥合角膜需求与实际收集的角膜之间的差距方面具有巨大潜力,这将对消除角膜性失明做出巨大贡献。在本研究中,医院死亡病例中角膜获取潜力为86%。