Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI.
Center for Vision and Eye Banking Research, Eversight, Cleveland, OH.
Cornea. 2023 Jan 1;42(1):89-96. doi: 10.1097/ICO.0000000000003137. Epub 2022 Oct 17.
The purpose of this study was to assess the impact of ongoing waves of the COVID-19 pandemic and resulting guidelines on the corneal donor pool with resumption of clinical operations.
A retrospective analysis of donors deemed eligible for corneal transplantation at an eye bank from July 1, 2020, through December 31, 2021. Donors ineligible due to meeting Eye Bank Association of America (EBAA) COVID-19 guidelines or a positive postmortem COVID-19 testing were examined. The correlation between COVID-19 rule outs and state COVID positivity was calculated. The number of scheduled surgeries, suitable corneas, imports, and international exports was compared with a pre-COVID period. Postmortem testing was reduced for the final 5 months of the study, and numbers were compared before and after the policy change.
2.85% of referrals to the eye bank were ruled out because of EBAA guidelines. 3.2% of postmortem tests were positive or indeterminate resulting in an ineligible tissue donor (0.42% of referrals). Over the 18-month period, there was a 4.30% shortage of suitable corneas compared with transplantation procedures. There was a significant correlation between postmortem testing and state COVID-19 positivity (r = 0.37, P <0.01), but not with EBAA guidelines (r = 0.19, P = 0.07). When postmortem testing was reduced, significantly more corneas were exported internationally.
Although corneal transplant procedures were back to normal levels, there was a shortage of suitable corneal tissue. The discontinuation of postmortem testing was associated with a significant increase in international exports of corneal donor tissue.
本研究旨在评估 COVID-19 大流行的持续浪潮及其导致的指南对角膜供体库的影响，此时临床业务已恢复。
对 2020 年 7 月 1 日至 2021 年 12 月 31 日期间在眼库被认为适合进行角膜移植的供体进行回顾性分析。不适合的供体是因为符合美国眼库协会 (EBAA) COVID-19 指南或死后 COVID-19 检测呈阳性。计算 COVID-19 排除与州 COVID 阳性率之间的相关性。与 COVID 前时期相比，比较了预定手术、合适的角膜、进口和国际出口的数量。在研究的最后 5 个月，死后检测减少，比较政策变更前后的数量。
2.85%的眼库转介因 EBAA 指南被排除在外。3.2%的死后检测呈阳性或不确定，导致组织供体不合格（占转介的 0.42%）。在 18 个月的时间里，与移植手术相比，合适的角膜短缺了 4.30%。死后检测与州 COVID-19 阳性率之间存在显著相关性（r = 0.37，P <0.01），但与 EBAA 指南之间无相关性（r = 0.19，P = 0.07）。当死后检测减少时，更多的角膜被出口到国际。
尽管角膜移植手术已恢复正常水平，但仍存在合适的角膜组织短缺。停止死后检测与角膜供体组织的国际出口显著增加有关。
