Strict protocols rule out SARS-CoV-2 transmission from corneal transplantation
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Current eye banking practices allow for safe provision and distribution of tissue for corneal transplantation, according to one speaker at the virtual European Society of Cataract and Refractive Surgeons meeting.
“With proper protocols in place, the risk of SARS-CoV-2 transmission from donor corneas is negligible,” Diego Ponzin, MD, medical director of Veneto Eye Bank, Venice, Italy, said. “In the very few corneas of asymptomatic donors that were found positive by postmortem nasopharyngeal swabs, we only found traces of SARS-CoV-2 RNA, without the capability of transmitting the infection.”
Veneto Eye Bank is one of the largest eye banks in Europe, delivering more than 50% of the corneal grafts used in Italy and many abroad. When Italy went on lockdown at the beginning of March and corneal transplantation procedures were halted, the bank reduced, but did not stop, the donation program.
“We put in place research and validation studies to prolong the expiry date of some ocular tissues and liaised with the health authorities to allow a restart of corneal transplantation surgery. We were successful, and hospitals reintroduced corneal transplantation in the last week of April, putting in place a specific COVID-19-free route for surgery. Recipients of corneal transplant were tested with nasopharyngeal swabs before and followed up after surgery with serology testing,” Ponzin said.
Mandatory postmortem testing of donors was also an opportunity to gain information on virus replication, immunity and infectivity in ocular tissue.
“In a total of 1,161 corneas of 588 donors, preselected based on history and medical records, only three patients (0.5%) tested positive for SARS-CoV-2, and of these, two corneas of two patients (0.3%) had traces of SARS-CoV-2 RNA. This proved that the ocular environment can host the virus and could potentially represent a risk, but we could not find any infective virus, only traces of RNA without the capability of producing an infection,” Ponzin said.
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Ponzin D. Corneal transplantation and eye banking in the era of Covid19. Presented at: European Society of Cataract and Refractive Surgeons meeting; Oct. 2-4, 2020 (virtual meeting).
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