Commentary: Eye banking during COVID-19 pandemic

The coronavirus disease 2019 (COVID 19) pandemic has affected the normalcy of our day to day lives with its high infectivity and the associated mortality, especially among health care workers. In the early days of the pandemic, all medical infrastructures were focussed on containing this problem which meant that even the needy nonemergency procedures were indefinitely delayed. The general hospitals were overwhelmed with providing care to a large number of patients. The mortuary workers, who usually champion the cause of organ donations, were burdened with demanding protocols. The potential risk of transmission to health care workers during corneal retrieval and processing and the possible risk of transmission of infection to the recipient through the donor cornea was a significant concern for all eye care professionals.[1] All these factors resulted in a complete cessation of eye donation activities in the initial months of the pandemic.

The most common indication for keratoplasty in India is still acute infective keratitis and the associated corneal perforation.[2] While elective procedures could wait, these eyes required urgent keratoplasty. Hence, there was an even more urgent need for professionals in our country to respond to the situation. The general secretary of the All India Ophthalmological Society (AIOS) took a lot of proactive steps and was in constant dialogue with the corneal surgeons as well as the nodal governmental agencies. Effective lobbying and the collaboration between the AIOS and the Eye Bank Association of India resulted in the guidelines being drafted keeping the welfare of all stakeholders in mind.[3] Screening donors based on medical symptoms, use of personal protective equipment during tissue retrieval, appropriate disinfection of the materials used, avoiding retrieval from COVID 19 designated hospitals, containment zones, and cessation of preparation of lamellar grafts were advocated to reduce the transmission of the virus. Routine testing for the presence of virus was not recommended.[3]

In this context, this article is very timely and the authors have highlighted the management of emergency corneal transplants and newer eye banking protocols that were adopted during and after the lockdown period in India.[4] It is gratifying to note that the eye donation movement has restarted. This rapid resurgence of the corneal donation movement with its attendant precautionary procedures is a standing testimony to the professional commitment of our ophthalmologists, eye donation activists, eye bank technicians, and more importantly a tribute to the generosity of the donors in these trying times.