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眼库中医院角膜获取与自愿眼捐赠项目的比较。

Comparison of Hospital Cornea Retrieval and Voluntary Eye Donation Program in Eye Banking.

作者信息

Sharma Namrata, Agrawal Nikhil, Maharana Prafulla K, Agarwal Tushar, Vanathi Murugesan, Vajpayee Rasik B

机构信息

Dr. Rajendra Prasad Centre for Ophthalmic Sciences (N.S., N.A., T.A., M.V.), All India Institute of Medical Sciences, New Delhi, India; Department of Ophthalmology (P.K.M.), All India Institute of Medical Sciences, Bhubaneswar, India; and Vision Eye Institute Melbourne (R.B.V.), Royal Victorian Eye and Ear Hospital, North West Academic Centre, University of Melbourne, Australia.

出版信息

Eye Contact Lens. 2018 Sep;44 Suppl 1:S54-S58. doi: 10.1097/ICL.0000000000000320.

DOI:10.1097/ICL.0000000000000320
PMID:28060143
Abstract

OBJECTIVES

Comparison of demographic, clinical, microbiological, and utility profile of the corneas obtained through hospital corneal retrieval program (HCRP) and voluntary eye donation (VED) program.

METHODS

Donor corneas retrieved during a 14 months period at National eye bank, India were included in the study. The donor cornea grading was done according to the cornea donor study. The corneal swabs were taken from the donor eyes and were sent for microbiological evaluation. The quality of the donor corneas and their utility was assessed.

RESULTS

Out of 1,014 donor corneas collected (700 through HCRP, 314 through VED), 455 were of optical grade (91.2% [415/455] through the HCRP and 8.7% [40/455] through the VED). HCRP had a higher proportion of donors in younger age (81.6% vs. 21%, P<0.0001), clear lens (78.6% vs. 66.2%, P<0.0001), and endothelial cell counts of more than2,000 cells per squared millimeter (64.9% vs. 28%, P<0.0001). Higher proportions of corneas in HCRP were used for optical indications (Penetrating keratoplasty, 24.5% vs. 13.3%, P<0.0001 and endothelial keratoplasty, 18.14% vs. 4.14%, P<0.0001). VED had a greater number of corneas found unsuitable for keratoplasty (37.4% vs. 6.4%, P<0.001). Most of the donors in the HCRP belonged to lower socioeconomic status (59.4% vs. 17.9%, P<0.0001). No significant difference was found in the microbial contamination between the two groups.

CONCLUSIONS

Most corneas retrieved through HCRP were of optical grade quality and efforts should be focused on HCRP to reduce the demand-supply deficit in cornea transplantation.

摘要

目的

比较通过医院角膜回收项目(HCRP)和自愿眼捐赠(VED)项目获得的角膜的人口统计学、临床、微生物学和效用特征。

方法

纳入印度国家眼库在14个月期间回收的供体角膜进行研究。根据角膜供体研究对供体角膜进行分级。从供体眼中采集角膜拭子并送去进行微生物学评估。评估供体角膜的质量及其效用。

结果

在收集的1014个供体角膜中(700个通过HCRP,314个通过VED),455个为光学级(通过HCRP的占91.2%[415/455],通过VED的占8.7%[40/455])。HCRP中年轻供体的比例更高(81.6%对21%,P<0.0001),晶状体透明的比例更高(78.6%对66.2%,P<0.0001),每平方毫米内皮细胞计数超过2000个细胞的比例更高(64.9%对28%,P<0.0001)。HCRP中更高比例的角膜用于光学适应症(穿透性角膜移植术,24.5%对13.3%,P<0.0001;内皮角膜移植术,18.14%对4.14%,P<0.0001)。VED中有更多角膜被发现不适合角膜移植(37.4%对6.4%,P<0.001)。HCRP中的大多数供体属于社会经济地位较低者(59.4%对17.9%,P<0.0001)。两组之间的微生物污染无显著差异。

结论

通过HCRP回收的大多数角膜为光学级质量,应将工作重点放在HCRP上以减少角膜移植中的供需缺口。

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