Glycerol-preserved corneal tissue in emergency corneal transplantation: An alternative for fresh corneal tissue in COVID-19 crisis

Abstract

Purpose: Due to the COVID-19 pandemic, most of the eye banks have limited/stopped corneal collection, as this is a highly contagious disease. This has led to shortage of donor corneas worldwide. Glycerol preservation of tissue remains a viable option in this scenario. The objective is to compare fresh corneal tissue (FCT) with glycerol-preserved cornea (GPC) in emergency corneal transplantation. Methods: This was a retrospective cohort study conducted in a tertiary care centre of Uttarakhand. Medical records of the patients who underwent therapeutic penetrating keratoplasty (TPK) were reviewed. FCT group included patients who underwent TPK with fresh corneal tissue and GPC group included patients who underwent TPK with glycerol preserved cornea. The indications and outcomes of TPK in the terms of therapeutic success were analysed and compared between both the groups. Results: A total of 94 eyes of 91 patients underwent TPK from October 2011 to August 2017. FCT group included 60 eyes of 57 patients and GPC group included 34 eyes of 34 patients. The primary indication of TPK was infectious keratitis in both the groups (FCT-81.6%; GPC - 91.2%) There was no significant difference in the therapeutic success in both the groups ( P = 0.741, Odds ratio- 1.59 with 95% CI- 0.39-6.44). Complications included glaucoma (FCT-21.7%; GPC- 35.2%) graft infection (FCT- 18.33% GPC- 2.9%); graft rejection (FCT-11.66%, GPC- 0%); and graft failure (FCT-88.33%, GPC-100%). Conclusion: The GPC is comparable to FCTs in therapeutic transplant and can be a useful interim procedure in saving the eyes in cases of infective keratitis in the time of crisis.

Impact of nationwide COVID-19 lockdown on keratoplasty and eye banking in India

“…It renders corneal tissues to be stored for indefinite period of time and are suited to developing nations where corneal transplants are performed primarily for therapeutic purposes, supply of corneal tissues are inadequate and post-transplant compliance is suboptimal. [ 5 6 ] In a comparative analysis of therapeutic success using fresh corneas (81.6%) versus glycerol preserved corneas (91.2%) Gupta[ 7 ] et al . have reported comparative success.…”

Impact of SARS-CoV-2 on Ocular Surface Pathology and Treatment Practices: a Review

“…Global donor shortages and delays due to regulatory testing may necessitate the need for long-term corneal storage in countries that rely on host countries as a tissue source. These long-term storage techniques include glycerol preservation, lyophilization, and gamma irradiation [29,30]. Glycerol preservation is the most adoptable technique, with reports of donor tissue storage for up to 10 years with clarity similar to fresh tissue [29,30].…”

A quick glance at publications on COVID-19 and ophthalmology

“…The use of irradiated corneas, glycerol preserved corneas for transplant, use of ultraviolet rays and hydrogen peroxide vapor for decontamination of respirators, and smartphone assisted slit-lamp examination are some of the novel and innovative applications brought into ophthalmic practice by this pandemic. [ 6 7 ] Ophthalmology trainees' surgical training has significantly suffered; however, there were several academic activities, including conferences and workshops facilitated by electronic media. [ 8 ]…”