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印度在与 COVID-19 相关的封锁期间,从一个三级眼科护理中心网络来看角膜移植和眼库的实践。

Corneal transplantation and eye banking practices during COVID-19-related lockdown period in India from a network of tertiary eye care centers.

机构信息

Cornea and Anterior Segment Services, L V Prasad Eye Institute, Vijayawada, Andhra Pradesh, India.

Cornea and Anterior Segment Services, L V Prasad Eye Institute, Bhubaneswar, Odisha, India.

出版信息

Indian J Ophthalmol. 2020 Nov;68(11):2368-2371. doi: 10.4103/ijo.IJO_2258_20.

Abstract

PURPOSE

The purpose of this study was to discuss the guidelines and modification of practices with respect to corneal transplantation and eye banking during the COVID-19 pandemic lockdown period and beyond, at a network of tertiary care centers in India.

METHODS

Descriptive study of the challenges faced in eye banking during the lockdown, and practices adopted to overcome the critical aspects in the clinical care of patients who presented with emergency corneal diseases requiring keratoplasty.

RESULTS

Complete lockdown orders from the Indian government, as a strategy to control the Coronavirus pandemic, resulted in drastic reduction of all types of elective corneal transplants and eye banking activities from March 24, 2020 to May 31, 2020. The sudden cessation of eye banking resulted in an acute demand and supply imbalance of fresh donor corneas for transplants during this time. Our network of eye banks addressed this issue by adopting glycerol preservation of donor corneas, which were subsequently utilized for tectonic penetrating keratoplasty. The donor cornea retrieval was resumed in a strategized manner 3 weeks prior to the date of exit of the lockdown, with modified guidelines on donor suitability, screening, retrieval, processing, and harvesting from various sources. A triage of keratoplasty priority was formulated to tide over the post lockdown shortage of corneas. We performed 31 therapeutic keratoplasties during the nationwide lockdown among our network of tertiary eye care centers.

CONCLUSION

The study highlights the approach and strategies to manage and tide over an unprecedented crisis situation faced by corneal surgeons in general and, specifically, the eye banking community.

摘要

目的

本研究旨在讨论在印度的一个三级护理中心网络中,在 COVID-19 大流行封锁期间及之后,针对角膜移植和眼库相关的指导原则和实践修正。

方法

对封锁期间眼库面临的挑战以及为克服紧急角膜疾病患者临床护理中关键方面所采取的措施进行描述性研究,这些患者需要进行角膜移植。

结果

印度政府实施的全面封锁令,作为控制冠状病毒大流行的策略,导致 2020 年 3 月 24 日至 2020 年 5 月 31 日期间所有类型的选择性角膜移植和眼库活动急剧减少。眼库的突然停止导致在这段时间内,新鲜供体角膜的供应严重失衡,无法满足移植的需求。我们的眼库网络通过采用甘油保存供体角膜来解决这个问题,随后将这些角膜用于组织穿透性角膜移植。在封锁解除前 3 周,以修改后的供体适宜性、筛选、检索、处理和从各种来源采集的指南为指导,以策略性的方式恢复了供体角膜的检索。制定了角膜移植优先级的分诊制度,以弥补封锁解除后角膜短缺的问题。在我们的三级眼科护理中心网络中,我们在全国性封锁期间进行了 31 例治疗性角膜移植。

结论

该研究强调了角膜外科医生(尤其是眼库社区)在面临前所未有的危机情况时的管理和应对方法和策略。

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本文引用的文献

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COVID-19 and eye banking.新型冠状病毒肺炎与眼库
Indian J Ophthalmol. 2020 Jun;68(6):1215-1216. doi: 10.4103/ijo.IJO_1033_20.
4
COVID-19 pandemic: Lessons learned and future directions.COVID-19 大流行:经验教训和未来方向。
Indian J Ophthalmol. 2020 May;68(5):703-710. doi: 10.4103/ijo.IJO_843_20.
5
Thirty years of eye bank experience at a single centre in India.印度一家中心30年的眼库经验。
Int Ophthalmol. 2020 Jan;40(1):81-88. doi: 10.1007/s10792-019-01164-y. Epub 2019 Aug 22.
7
Global Survey of Corneal Transplantation and Eye Banking.全球角膜移植与眼库调查
JAMA Ophthalmol. 2016 Feb;134(2):167-73. doi: 10.1001/jamaophthalmol.2015.4776.
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Turning the tide of corneal blindness.扭转角膜盲的潮流。
Indian J Ophthalmol. 2012 Sep-Oct;60(5):423-7. doi: 10.4103/0301-4738.100540.

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