Originally published in NKCF Update (December 2021)
What happens during a pandemic?
The Eye Bank Association of America (EBAA) is a coalition of 57 non-profit eye banks operating throughout the US. Their efforts have resulted in over 2 million corneal transplants by member eye banks in the last 60 years.
In March 2020, as the cases of COVID-19 increased, hospitals refocused their resources and temporarily halted non-emergency surgery like corneal transplants. Eye banks hurried to create new guidelines to safeguard their staff and limit transmission of disease to tissue recipients. By April 2020, 90% or more of corneal transplant surgeries were postponed or cancelled. While available tissue dropped to an all-time low, so did the demand.
During the next several months, EBAA officials, scientists and clinicians came up with new screening protocols for accepting cornea tissue donations and restarting eye bank operations. Policies implemented in the first few months of the pandemic included anyone who died from COVID-19 or anyone exposed to COVID-19 during their final month could not be a donor. Technicians retrieving donor tissue would review medical records to look for evidence that the deceased had a recent negative COVID test result. Some eye banks began performing postmortem nasal swab tests to look for evidence of the virus on donors who are asymptomatic at the time of their death. Processing and testing of recovered cornea tissue was also been expanded as an additional safeguard.
Dr. Shahzad Mian, MD, from the Kellogg Eye Center at the University of Michigan summarized the dilemma, to “make sure that we address the concern with risk of transmission from donors who are COVID-19 positive or could be COVID-19 positive, (and) the fact that we have patients blind from corneal disease who need their eye surgeries to be able to see.”
In 2019, more than 85,000 corneas were retrieved by EBAA-member eye banks and used in the US and internationally. That number fell to 66,000 during 2020, and there was a drop of 20% in the number of corneal transplant surgeries performed. It will be interesting to learn if 2021 ends with a return to pre-pandemic numbers, or if the new guidelines result in fewer donated corneas available for transplant.
Reference: Ballouz D, Sawant OB, et al, Impact of the COVID-19 Pandemic on Keratocplasty and Corneal Eye Banking, Curr Opin Ophthalmol, 40:1018-1023, 2021.
Dr. Shahzad Mian MD is Professor of Ophthalmology and a Vice Chair for Clinical Sciences and Learning at Kellogg Eye Center at the University of Michigan. He is a graduate of Emory University School of Medicine and did his training in ophthalmology at Wills Eye Hospital before completing a cornea fellowship at the Massachusetts Eye & Ear Infirmary. Dr. Mian has been on the faculty at UM since 2002. He serves as the Medical Director for Eversight, the Eye Bank of Michigan, and is a member of several national eye banking and transplantation committees.