Resuming eye bank services during the COVID-19 pandemic

Abstract

Purpose: The aim of this study was to formulate a methodological approach for resuming eye bank services during COVID-19 pandemic. Methods: Eye bank operations were temporarily halted in March after the government-mandated “Lockdown” in response to COVID-19 pandemic. Before restarting eye bank operations in May, we studied sources of exposure, performed risk assessment, instituted additional process validations and redefined the Standard Operating Procedures (SOPs) in consultation with the guidelines published by the Eye bank Association of India and All India Ophthalmological Society. The eye bank staff were rigorously trained before and after operations were restarted. We conducted a survey at the end of July to gauge staff attitude and reaction. Results: Eye banks services resumed on 20 th May 2020. Since reopening till the end of July total 41 keratoplasties have been done. 91.75% of all keratoplasties done were therapeutic surgeries and 17% of the surgeries were done using glycerine preserved tissues. No staff had COVID-19 symptoms when the operations restarted and none developed symptoms up to the end of July. All eye bank staff were aware of COVID-19 pandemic and 86% said they felt safe working at the eye bank. 86% of the staff said that they received adequate training and 66% of the staff expressed that they always received proper PPE and kits. Overall, 93% of the staff expressed that the measures taken by the eye bank ensured their safety. Conclusion: Based on our experience we suggest the following activities for planned resumption of eye bank services during the pandemic: Exposure Risk Analysis, Personal Protective Equipment usage training, SOP Revision and staff training on modified SOPs. Criteria based selection of donor sources, participatory planning involving the staff and double-checking at critical process junctions helped us in managing a smooth transition.

Immediate impact of COVID-19 on eye banking in India

“…Acharya et al . [ 10 ] have published a good framework for comprehensive operating protocols for restarting eye bank services. Though 82% of the eye banks in our survey provided additional training to staff before resuming operations, the 18% gap does bother us.…”

Effect of Covid-19 on Eye Banks and Corneal Transplantations: Current Perspectives

“… 19 Similar situations were reported virtually in the entire globe, including India, Germany and Canada. 24 , 28 , 29 Both AlShaker et al and Acharya et al reported Eye Bank Staff to have been trained to the appropriate and constant use of personal protective equipment, and exposure risk analysis strategies (e.g., questionnaires, body temperature check, nasopharyngeal swab, etc.) to have been implemented to minimize the risk of in bank SARS-CoV-2 transmission.…”

“…Standardized operating procedures (SOP) needed to be revised, too. An increasing number of checkpoints were added to avoid unnoticed potential exposure to SARS-CoV-2 (e.g., checklist for double-checking donor medical history and a detailed tissue tracker), according to the experience of Acharya et al 29 …”

“…19 Similar situations were reported virtually in the entire globe, including India, Germany and Canada. 24,28,29…”

“…24,29 Standardized operating procedures (SOP) needed to be revised, too. An increasing number of checkpoints were added to avoid unnoticed potential exposure to SARS-CoV-2 (e.g., checklist for double-checking donor medical history and a detailed tissue tracker), according to the experience of Acharya et al 29 In addition, as suggested by the EBAA, double disinfection of cornea donors with povidone iodine before removal and preparation of the eye globe was confirmed or adopted in daily practice. 30 In fact, Sawant et al noted none of the povidone iodine pre-treated cornea donor resulting positive for SARS-CoV-2 RNA.…”