A research paper by Taiwanese doctors could change the accepted view that corneas from patients with bacteremia cannot be transplanted and help increase the supply for those awaiting donor corneas.
Standard practice for eye banks is to reject organs donated by bacteremic patients, as they could be contaminated, said National Taiwan University Hospital Department of Ophthalmology director Hu Fung-rong (胡芳蓉), one of the authors of the research paper.
Bacteremia is the condition where bacteria are present in a patient’s blood, which is usually a sterile environment. The cornea is the outer layer of the eye and helps focus vision.
Photo: Lin Hui-chin, Taipei Times
The blood-aqueous humor barrier and the blood-retinal barrier in human eyes make it difficult for bacteria in blood to enter the eyes, Hu said, adding that the cornea itself has no veins and is even less likely to become contaminated.
Recent research has begun questioning the need to reject such tissue from bacteremic donors, which was a catalyst for the research, she said.
The researchers analyzed corneas from 454 donors at the National Eye Bank of Taiwan from January 2014 to June 2017, Hu said, adding that they analyzed 70 sets of corneas from bacteremic donors and 627 sets from non-bacteremic donors.
The blood culture results showed that the average microbial contamination rates of the corneas from bacteremic and non-bacteremic donors were 7.1 percent and 9.1 percent respectively, and they had similar endothelial cell densities, Hu said.
The research paper was on Oct. 15 last year published in the British Journal of Ophthalmology.
Ministry of Health and Welfare Department of Medical Affairs
Director-General Shih Chung-liang (石崇良) on Thursday said that more than 60 percent of corneas for transplant were imported from foreign eye banks, which has consequences for surgery results and costs patients between NT$50,000 to NT$100,000.
The research results could help increase the supply of corneas and further lower the burden on patients, after the National Eye Bank was established in 2013 and the National Health Insurance started covering transplantation costs, Shih said.
Average wait times for cornea transplants have dropped from 123 days to 96.5 days since the eye bank was established, but there is always room for improvement, Hu said.
People should seek a cornea transplant if the top layer of their eye becomes “cloudy” or they develop corneal edema, which can happen due to trauma from traffic accidents, infection or other causes.
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