Changing pattern of utilization of human donor cornea in India.
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Date
2015-08
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Abstract
Purpose: To review the changing pattern of donor, corneal utilization in an eye bank at a Tertiary Care Center
in Northern India by analyzing the trend in the years 2003, 2008, and 2011. Methods: A retrospective review
of eye bank records for 3 years (2003, 2008, and 2011) was performed at the National Eye Bank. Details
including a clinical grade of donor cornea, indication of corneal transplantation (therapeutic or optical),
type of procedure (penetrating or lamellar keratoplasty [LK]), and clinical diagnosis of the graft recipients
were recorded. Primary outcome measure was to observe any preference toward LK, judicious usage of
donor corneal tissue, and impact of lamellar corneal transplant in the usage of donor corneas. Secondary
outcomes included overall utilization rate and change in trend of indication for keratoplasty. Results: A total
of 673, 745, and 864 corneas were retrieved in the years 2003, 2008, and 2011, respectively. The percentage of
donor corneal utilization increased significantly over time with the rate being 65.08%, 70.06%, and 68.29%,
respectively, in the years 2003, 2008, and 2011 (P = 0.014); however, this change was reflected only in the
usage of nonoptical grade corneas and not for the optical grade corneas. There was an overall increase in
lamellar corneal procedures for any clinical grade of cornea (P = 0.0019); number of Descemet’s stripping
automated endothelial keratoplasty (DSAEK) procedures increased significantly (P < 0.001), particularly
for pseudophakic corneal edema (PCE) (P = 0.0085) and failed graft (P = 0.002). Significant increase in the
utilization of nonoptical grade corneas was observed over the years (P = 0.005), though the utilization did
not increase significantly for optical purposes viz., LK (P = 0.08). Conclusions: Utilization rate of donor
corneas increased over the years, primarily due to increase in usage of nonoptical grade corneas for
therapeutic purposes. There was a procedural shift toward DSAEK for PCE and failed graft. However, an
increase in usage of nonoptical grade corneas for LK, a single donor corneal tissue for two recipients, and
retrieval or utilization of optical grade cornea was not observed.
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Keywords
Donor corneal utilization, eye bank, keratoplasty, split corneal surgery, trend
Citation
Gogia Varun, Gupta Shikha, Agarwal Tushar, Pandey Veena, Tandon Radhika. Changing pattern of utilization of human donor cornea in India. Indian Journal of Ophthalmology. 2015 Aug; 63(8): 654-658.