Abstract
Purpose :
Currently, an estimated 1 in 70 individuals worldwide in need of a corneal transplant will actually undergo corneal transplantation. There is a lack of objective data explaining the underlying reasons for why this discrepancy exists. The purpose of this study was to use a newly developed questionnaire to identify the barriers for successfully performing corneal transplantation in India.
Methods :
An online survey was sent to approximately 700 currently-practicing corneal specialists who were members of the Cornea Society of India. Members were invited to complete an online survey between January 1 and July 1, 2021. The survey asked the participants to rate the difficulty or ease of 11 steps of corneal transplantation using a Likert scale. Categories included factors related to donors, organ procurement, tissue
harvesting/storage, logistical, physician/staff/facility related, and recipient related.
Results :
A total of 148 individuals participated in the online survey (~21% response rate). Of the 11 evaluated steps, the greatest barrier to transplantation was the difficulty in finding donors who fulfilled the screening criteria (55% of respondents reported difficulty). The second greatest barrier was donor willingness to donate (32% of respondents reported difficulty). Lastly, the third most reported barrier was the ability to store tissue after it was prepared by the eye bank (20% of respondents reported difficulty). The two steps with the least reported difficulty were availability of operating room (OR) time and staff, as well as using prepared corneal tissue before the expiration date.
Conclusions :
There is a significant shortage of corneal transplants performed around the world, however there has never been a standardized way of identifying forces driving this shortage. Our online survey evaluated each step needed to successfully perform corneal transplantation. In India, it appears that the donor-related factors (both fulfilling donor criteria and patient/family willingness to donate) and ability to store prepared tissue were the greatest barriers in performing corneal transplantation. Therefore, both government and private institutions should focus their resources and efforts on addressing these issues to ultimately reduce the burden of corneal blindness.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.