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Behera G, Vijayan N, Murugesan R, Sangaraju S, Kasturi N, Sahi A, Jayasri P, Babu KR. Impact of an educational video in improving awareness of eye donation among non-medical health care workers in a tertiary health centre. Int Ophthalmol 2024; 44:289. [PMID: 38937283 DOI: 10.1007/s10792-024-03189-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 06/15/2024] [Indexed: 06/29/2024]
Abstract
PURPOSE To evaluate the impact of an educational video in improving awareness of eye donation among non-medical healthcare workers at a tertiary health centre. METHODS A socio-behavioural study on knowledge and attitude towards eye donation was conducted among 373 non-medical healthcare workers through a printed semi-structured questionnaire before and after viewing a bilingual educational video. The responses were evaluated and scored. RESULTS Pre-intervention, only 5.4% of the participants had adequate knowledge, which improved significantly to 71.6% after watching the video (P < .001). Respondents with elementary school education showed the greatest change in knowledge. Pre-intervention, 72.4% were willing to donate their eyes, which significantly increased to 89.5% after watching the video. Pre-intervention, 66.22% showed a "highly favourable" attitude, which improved to 97.86% after watching the video. CONCLUSION The 25 min video about eye donation and eye banking significantly changed the participants' knowledge, willingness, and attitude. Hence, media-based (video) awareness platforms may be valuable for improving the general public's knowledge and attitude towards eye donation. This may help in enhancing the eye donation rate in the long term.
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Affiliation(s)
- Geeta Behera
- Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India.
| | - Niranjan Vijayan
- Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - Rajeswari Murugesan
- Department of Biostatistics, All India Institute of Medical Sciences (AIIMS), Mangalagiri, India
| | - Suneel Sangaraju
- Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - Nirupama Kasturi
- Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - Arun Sahi
- Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - P Jayasri
- Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - Krishna Ramesh Babu
- Department of Ophthalmology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, India
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Rawashdeh S, ALBashtawy M, Bani Hani S, ALBashtawy B, Ayed A, Alkhawaldeh A, Abdalrahim A, Khatatbeh H, Suliman M, ALBashtawy S, Oweidat IA, Al-Amer R, ALBashtawy Z. Jordanian nursing students' knowledge and attitudes of corneal donation. Cell Tissue Bank 2024:10.1007/s10561-024-10145-0. [PMID: 38926207 DOI: 10.1007/s10561-024-10145-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
A high success rate of corneal transplants is evident. However, there is still a lack of corneal grafts available to meet demand, largely because donors are reluctant to donate. Given their critical role in future healthcare teaching and advocacy. There has not been much research on Jordanian nursing students' perspectives on corneal donation, so it's critical to identify and eliminate any obstacles. This study aims to evaluate the knowledge and attitudes of Jordanian nursing students concerning corneal donation. A cross-sectional, descriptive design was used to recruit (n = 440) nursing students from four Jordanian universities. A self-reported questionnaire was used to obtain data on knowledge and attitudes regarding corneal donation. The average age of senior nursing students was (M = 23.07, SD = 3.63) years. Varying levels of understanding were revealed amongst university students toward corneal donation items. Generally, good attitude of nursing students toward corneal donation (M = 34.1, SD = 8.1). Weak positive relationship was found between total knowledge scores and age (r = 0.141, p = 0.003) while there is no significant relationship between age and total attitude score (r = 0.031, p = 0.552). Age was found to be a significant predictor (B = 0.01, Beta = 0.12, t = 2.07, p = 0.04). Also, the educational level of fathers is a significant positive predictor (Beta = 0.128, p = 0.008) for the total attitude scores among nursing students. Limited awareness of corneal donation, highlighting the need for focused educational interventions to improve their comprehension.
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Affiliation(s)
| | | | - Salam Bani Hani
- Irbid National University Faculty of Nursing, Irbid, Jordan.
| | | | - Ahmad Ayed
- Arab American University, Palestine, Palestine
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Nathawat R, Farooqui JH, Majumdar A, Acharya M. Eye Donation Counsellor Skill Evaluation Tool (EDC-SET): A step toward improved eye donation counseling. Indian J Ophthalmol 2024; 72:76-80. [PMID: 38131574 PMCID: PMC10841774 DOI: 10.4103/ijo.ijo_2031_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/25/2023] [Accepted: 09/04/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE The expansion of the Hospital Corneal Retrieval Programme (HCRP) and the role of Eye Donation Counsellors (EDCs) have shown promising results in increasing donor cornea availability. To further enhance EDC competency and improve cornea availability for transplantation, the study proposes the Eye Donation Counsellor Skill Evaluation Tool (EDC-SET). Key words: Competency assessment, corneal blindness, Eye Donation Counsellors (EDCs), eye health, Hospital Corneal Retrieval Programme (HCRP), skill evaluation. METHODS A competency framework for EDCs and a tool for evaluation of the competency level (EDC-SET) was designed, along with scripts for emulating realistic counselling scenarios. Independent assessors were trained on using EDC-SET and evaluated EDCs participating in role-plays based on the pre-designed scripts. EDCs were briefed a priori on the EDC-SET but not on the role play scripts which were used during evaluation. RESULTS We piloted the tool at a tertiary eye hospital, and it was found to capture EDC competency reliably. The study evaluated seven EDCs each assessed by two independent assessors. Conformity, kappa, and intraclass correlation coefficient (ICC) values were calculated to estimate the parameter-wise reliability of the EDC-SET. The results suggest that the scores from both assessors closely matched for most of the parameters, and overall, their ratings showed moderate agreement. The difficulty level of each parameter as assessed by the two assessors was also calculated. It was observed that most participants found "Initiation of the Case" and "Empathy and Emotional Support" challenging. However, "Body Language," "Cultural Awareness," and "Attentiveness to Family Dynamics" were perceived as relatively easy or not difficult by participants. CONCLUSION Evaluation of EDCs using EDC-SET revealed the varying competency levels of EDCs and showed agreement on the evaluation between the assessors. Implementing the EDC-SET could help standardise the mapping and measurement of the skill set of EDCs, thereby enhancing their performance and reducing corneal blindness in India.
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Affiliation(s)
- Rakhi Nathawat
- Departments of Cornea and Anterior Segment, Dr. Shroff’s Charity Eye Hospital, New Delhi, India
| | | | - Atanu Majumdar
- Department of Statistics, Dr. Shroff’s Charity Eye Hospital, New Delhi, India
| | - Manisha Acharya
- Departments of Cornea and Anterior Segment, Dr. Shroff’s Charity Eye Hospital, New Delhi, India
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Parija S, Chakraborty K, Sahu DP. A study on knowledge, attitude, and practice about eye donation among medical students and healthcare professionals at a tertiary hospital in Eastern India. Indian J Ophthalmol 2023; 71:3513-3520. [PMID: 37870016 PMCID: PMC10752322 DOI: 10.4103/ijo.ijo_2554_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 06/27/2023] [Accepted: 07/17/2023] [Indexed: 10/24/2023] Open
Abstract
Purpose To assess and analyze the rate of knowledge, attitude, and practice patterns about eye donation among medical and healthcare professionals in a tertiary care hospital in eastern India. Methods This was a cross-sectional, descriptive study conducted on medical students, resident doctors, and nursing and paramedical staff at a tertiary institute in the year 2020. A pretested, structured questionnaire consisting of 28 questions in the three subsections based on knowledge and awareness, attitudes and beliefs, and practice patterns mainly willingness to donate eyes by pledging, was noted. All the responses were individually scored, and the total scores were calculated. Univariate analysis was done to find out the factors that had a positive or negative influence on the knowledge and willingness about eye donation. Results Around 270 participants responded to this survey. The majority of the respondents (206, 76.3%) were below 30 years and 64.4% were males. Awareness about eye donation was 95.6% but a willingness to pledge was observed in 51.5% of participants. The total practice score was lower among nonmedicos compared with medicos (3.33 ± 1.22 vs 3.74 ± 0.64), (P < 0.001). On univariate analysis, the Crude Odds Ratio with a 95% confidence interval was 25.787 (5.18-128.33) in the occupational category (P < 0.001). Conclusion The study reported an adequate knowledge level among doctors and healthcare workers. The practice pattern among the nursing staff and paramedical workers needs to be improved as they can play a pivotal role in strengthening the hospital corneal retrieval program. They can also be the key messengers during public awareness campaigns for eye donations in our country.
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Affiliation(s)
- Sucheta Parija
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Koyel Chakraborty
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Dinesh Prasad Sahu
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Panigrahi S, Mahapatra B, Pati S, Jena S, Murmu SK, Mohanty P. Obstacles to Post-mortem Cornea Donation: A Study From a Tribal Region in Eastern India. Cureus 2022; 14:e25176. [PMID: 35747021 PMCID: PMC9209337 DOI: 10.7759/cureus.25176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose: Studying the cognizance and hindrances of eye benefactors amongst relatives of post-mortem cases in an Indian tertiary referral centre. Methods: This prospective study was executed at a tertiary hospital. In this examination, the relatives had been approached and counselled systematically. The responses had been noted in a predesigned proforma. Data regarding demographic details, socioeconomic status, prior knowledge of eye benefactor, willingness and reasons for refusing eye benefactor, literacy level, relationship with the deceased patient, and so on were collected. Results: One hundred fifty-six potential donors had been identified from 845 post-mortem cases. Among these potential donors were 63 women and 93 men. Thirty-eight next of kin had been seen as already cognizant regarding eye benefactor; however, other 118 families were unaware. A total of 109 families refused to donate eyes while other 47 showed willingness for the procedure. It was seen that there was no influence on literacy status, socioeconomic status and prior knowledge regarding the concept of willingness to donate. Conclusion: Counselling for eye benefactor exercises a crucial role in procuring corneas. Socioeconomic status, literacy and prior understanding of eye donation had no link with donor corneal tissue procurement in our study. Even in families with no prior knowledge and poor socioeconomic status, active counselling can be successful.
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Gill JS, Shrolff S. Response to "Comment - Bold policy changes are needed to meet the need for organ transplantation in India". Am J Transplant 2022; 22:326-327. [PMID: 34355497 DOI: 10.1111/ajt.16787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/02/2021] [Indexed: 01/25/2023]
Affiliation(s)
- John S Gill
- University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Sunil Shrolff
- Urology and Transplantation, Madras Medical Mission Hospital, Chennai, India
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Moreira-Almeida A, Koenig HG. Spirituality and Ophthalmology. REVISTA BRASILEIRA DE OFTALMOLOGIA 2021. [DOI: 10.37039/1982.8551.20210047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Bracher M, Madi-Segwagwe BC, Winstanley E, Gillan H, Long-Sutehall T. Family refusal of eye tissue donation from potential solid organ donors: a retrospective analysis of summary and free-text data from the UK National Health Service Blood and Transplant Services (NHS-BT) National Referral Centre (1 April 2014 to 31 March 2017). BMJ Open 2021; 11:e045250. [PMID: 34518244 PMCID: PMC8438759 DOI: 10.1136/bmjopen-2020-045250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Long-standing undersupply of eye tissue exists both in the UK and globally, and the UK National Health Service Blood and Transplant Service (NHSBT) has called for further research exploring barriers to eye donation. This study aims to: (1) describe reported reasons for non-donation of eye tissue from solid organ donors in the UK between 1 April 2014 and 31 March 2017 and (2) discuss these findings with respect to existing theories relating to non-donation of eyes by family members. DESIGN Secondary analysis of a national primary data set of recorded reasons for non-donation of eyes from 2790 potential solid organ donors. Data analysis including descriptive statistics and qualitative content analysis of free-text data for 126 recorded cases of family decline of eye donation. SETTING National data set covering solid organ donation (secondary care). PARTICIPANTS 2790 potential organ donors were assessed for eye donation eligibility between 1 April 2014 and 31 March 2017. RESULTS Reasons for non-retrieval of eyes were recorded as: family wishes (n=1339, 48% of total cases); medical reasons (n=841, 30%); deceased wishes (n=180, 7%). In >50% of recorded cases, reasons for non-donation were based on family's knowledge of the deceased wishes, their perception of the deceased wishes and specific concerns regarding processes or effects of eye donation (for the deceased body). Findings are discussed with respect to the existing theoretical perspectives. CONCLUSION Eye donation involves distinct psychological and sociocultural factors for families and HCPs that have not been fully explored in research or integrated into service design. We propose areas for future research and service development including potential of only retrieving corneal discs as opposed to full eyes to reduce disfigurement concerns; public education regarding donation processes; exploration of how request processes potentially influence acceptance of eye donation; procedures for assessment of familial responses to information provided during consent conversations.
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Affiliation(s)
- Mike Bracher
- School of Health Sciences, University of Southampton, Southampton, Hampshire, UK
| | | | - Emma Winstanley
- National Health Service Blood and Transplant Services-Organ and Tissue Donation and Transplantation, Liverpool, UK
| | - Helen Gillan
- National Health Service Blood and Transplant Services-Organ and Tissue Donation and Transplantation, Liverpool, UK
| | - Tracy Long-Sutehall
- School of Health Sciences, University of Southampton, Southampton, Hampshire, UK
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Siddharthan KS, Agrawal A, Reddy JK. A simple surgical technique for splitting a single donor cornea for performing deep anterior lamellar keratoplasty and Descemet membrane endothelial keratoplasty without using a microkeratome. Indian J Ophthalmol 2021; 69:2441-2445. [PMID: 34427240 PMCID: PMC8544036 DOI: 10.4103/ijo.ijo_3044_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose: To describe a simple manual surgical technique for splitting a single-donor eye for performing both deep anterior lamellar keratoplasty (DALK) and Descemet membrane endothelial keratoplasty (DMEK) without using a microkeratome. Methods: Twenty-three eyes with anterior stromal pathology and 23 eyes with irreversible endothelial dysfunction were evaluated for keratoplasty at a tertiary eye care referral center. Twenty-three healthy donor corneas were split into two parts. The Descemet’s membrane was stripped and used for DMEK. The stripped stroma was used for DALK. Best-corrected visual acuity (BCVA) of both DALK and DMEK, endothelial cell density, and endothelial cell loss in DMEK were noted at 1-year follow-up, along with any intraoperative or postoperative complications and failures. Results: In the DALK group, mean BCVA improved from 1.264 ± 0.25 log Mar preoperatively to 0.355 ± 0.27 log Mar at 12 months follow-up. There were no complications and failures. In the DMEK group, mean BCVA improved from 1.537 ± 0.61 log Mar preoperatively to 0.592 ± 0.67 log Mar and the mean donor ECD was 3071.66 (range, 2783–3487) cells/mm2 preoperatively, which was reduced to 1989.33 (range, 1546–2543) cells/mm2 at 12 months follow-up indicating a mean endothelial cell loss of 35%. The failure rate was 21.7%. Conclusion: This study demonstrates that with a single donor corneal tissue, both DALK and DMEK can be performed successfully without any complications. Our technique will help corneal surgeons in all developing countries to cost effectively perform more lamellar surgeries and help in reducing the magnitude of corneal blindness without the need for expensive microkeratomes.
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Affiliation(s)
- K S Siddharthan
- Head-Cornea Services, Sankara Eye Hospital, Coimbatore, India
| | - Anushri Agrawal
- Fellow, Cornea Services, Sankara Eye Hospital, Coimbatore, India
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Milner I, Hussain N, Imoru P, Shah H. Comments: Pendleton's Ideas, Concerns and Expectations model for improving outcomes through eye donation counseling. Indian J Ophthalmol 2021; 69:1019-1020. [PMID: 33727493 PMCID: PMC8012926 DOI: 10.4103/ijo.ijo_3184_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Imogen Milner
- 3rd Year Medical Student, Clinical Medical Students, University of Birmingham, Birmingham, UK
| | - Naveed Hussain
- 3rd Year Medical Student, Clinical Medical Students, University of Birmingham, Birmingham, UK
| | - Princess Imoru
- 3rd Year Medical Student, Clinical Medical Students, University of Birmingham, Birmingham, UK
| | - Haroon Shah
- 5th Year Medical Student, Clinical Medical Students, University of Birmingham, Birmingham, UK
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Aggarwal H, Gupta N, Garg P, Sharma M, Mittal S, Kant R. Hospital Cornea Retrieval Programme in a startup eye bank - A retrospective analysis and lessons learned. Indian J Ophthalmol 2021; 69:1517-1521. [PMID: 34011733 PMCID: PMC8302265 DOI: 10.4103/ijo.ijo_2455_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Purpose: This study aimed to share our experience in the hospital cornea retrieval program as a new eye bank. Methods: This was a retrospective study conducted in a tertiary care institute from August 26, 2019 to March 22, 2020. The medical and eye bank records were analyzed for hospital mortality, mortuary records, and donors approached. The corneal collection was divided between Voluntary (received from voluntary calls), HCRP (cornea received from hospital deaths), and Medico-Legal Cases (received from MLC deaths in hospital) to see the trend of donation and utilization over time. Results: During the study period, 154 corneas (77 pairs) were collected. The HCRP provided a major source of corneas 58.4% (90 corneas) as compared to voluntary 19.5% (30 corneas) and MLC 22.1%(34 corneas). There were younger tissues in MLC than HCRP donors, and older tissues in Voluntary donors, and the difference was statistically significant. There was no significant difference in the quality of optical grade tissues and the utilization of corneas for transplants between the three groups. Post hoc analysis showed more non-optical tissues in the voluntary donations (P = 0.004), maximum donors with medical contraindications in the HCRP group (P = 0.001), and time-lapse in corneal retrieval in MLC cases (P = 0.0001). Of these 154 corneas, 78 (50.6%) were assessed as suitable for transplantation, of which 59 (75.6%) tissues were optical grade tissues. The overall utilization was 39.6%. Conclusion: HCRP is indeed challenging for a new eye bank, but proper understanding and implementing strategies may help for good utilization of tissues.
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Affiliation(s)
- Himanshi Aggarwal
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Dehradun, Uttarakhand, India
| | - Neeti Gupta
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Dehradun, Uttarakhand, India
| | - Prashant Garg
- Director, Kallam Anji Reddy Campus, Director, Kode Venkatadri Chowdary Campus, Network Head of Eye Banking and Consultant, The Cornea & Anterior Segment Services, The Cornea Institute (TCI), LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Manisha Sharma
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Dehradun, Uttarakhand, India
| | - Sanjeev Mittal
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Dehradun, Uttarakhand, India
| | - Ravi Kant
- Director and CEO, All India Institute of Medical Sciences, Rishikesh, Dehradun, Uttarakhand, India
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Arora R, Goel R, Malhotra V, Kumar S. Redefined role of eye bank counselors during COVID-19 pandemic. Indian J Ophthalmol 2021; 69:452-453. [PMID: 33380620 PMCID: PMC7933882 DOI: 10.4103/ijo.ijo_3185_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ritu Arora
- Department of Ophthalmology (Guru Nanak Eye Centre), Maulana Azad Medical College, New Delhi, India
| | - Ruchi Goel
- Department of Ophthalmology (Guru Nanak Eye Centre), Maulana Azad Medical College, New Delhi, India
| | - Vikas Malhotra
- Department of ENT, Maulana Azad Medical College, New Delhi, India
| | - Suresh Kumar
- Department of Medicine, Maulana Azad Medical College, New Delhi, India
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Price MO, Mehta JS, Jurkunas UV, Price FW. Corneal endothelial dysfunction: Evolving understanding and treatment options. Prog Retin Eye Res 2020; 82:100904. [PMID: 32977001 DOI: 10.1016/j.preteyeres.2020.100904] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/14/2020] [Accepted: 09/19/2020] [Indexed: 12/13/2022]
Abstract
The cornea is exquisitely designed to protect the eye while transmitting and focusing incoming light. Precise control of corneal hydration by the endothelial cell layer that lines the inner surface of the cornea is required for optimal transparency, and endothelial dysfunction or damage can result in corneal edema and visual impairment. Advances in corneal transplantation now allow selective replacement of dysfunctional corneal endothelium, providing rapid visual rehabilitation. A series of technique improvements have minimized complications and various adaptations allow use even in eyes with complicated anatomy. While selective endothelial keratoplasty sets a very high standard for safety and efficacy, a shortage of donor corneas in many parts of the world restricts access, prompting a search for alternatives. Clinical trials are underway to evaluate the potential for self-recovery after removal of dysfunctional central endothelium in patients with healthy peripheral endothelium. Various approaches to using cultured human corneal endothelial cells are also in clinical trials; these aim to multiply cells from a single donor cornea for use in potentially hundreds of patients. Pre-clinical studies are underway with induced pluripotent stem cells, endothelial stem cell regeneration, gene therapy, anti-sense oligonucleotides, and various biologic/pharmacologic approaches designed to treat, prevent, or retard corneal endothelial dysfunction. The availability of more therapeutic options will hopefully expand access around the world while also allowing treatment to be more precisely tailored to each individual patient.
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Affiliation(s)
- Marianne O Price
- Cornea Research Foundation of America, 9002 N. Meridian St., Suite 212, Indianapolis, IN, USA.
| | - Jodhbir S Mehta
- Singapore National Eye Centre, 11 Third Hospital Ave #08-00, 168751, Singapore
| | - Ula V Jurkunas
- Massachusetts Eye and Ear Infirmary, 243 Charles St., Boston, MA, USA
| | - Francis W Price
- Price Vision Group, 9002 N. Meridian St., Suite 100, Indianapolis, IN, USA
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