Impact of quality assurance on utilization of corneal tissues in a community Eye Bank

Manisha Acharya; Saurabh Biswas; Animesh Das; Abhishek Dave; Umang Mathur

doi:10.1016/j.joco.2019.07.001

Impact of quality assurance on utilization of corneal tissues in a community Eye Bank

J Curr Ophthalmol. 2019 Aug 2;31(4):387-393. doi: 10.1016/j.joco.2019.07.001. eCollection 2019 Dec.

Authors

Manisha Acharya¹, Saurabh Biswas¹, Animesh Das¹, Abhishek Dave¹, Umang Mathur¹

Affiliation

¹ Dr. Shroff's Charity Eye Hospital, New Delhi, India.

Abstract

Purpose: To determine the linkage between Quality Assurance Program (QAP) and increase in utilization of donor corneas at a community Eye Bank.

Methods: A donor cornea is defined as utilized when it is used for cornea transplant. Two metrics, utilization rate (UR) and non-utilization rate (NUR), were defined. The Eye Bank implemented QAP from 2011. As a part of QAP, detailed gap analysis of tissue utilization was performed. Four major categories causing non-utilization of recovered corneas were identified. These categories were poor "Tissue Quality", "Seropositive" donor blood sample, "Medical History" of donor, and donor "Blood Sample Issues." The years 2008-2011 were labelled the pre-intervention period, and the years 2012-2017 were labelled the post-intervention period. Annual UR and annual NUR for the four categories of non-utilization from the pre and the post-intervention periods were statistically compared.

Results: In the pre-intervention period, the Eye Bank recovered 1425 donor corneas in total and transplanted 762. In the post-intervention period, the Eye Bank recovered 6661 corneas in total and transplanted 4393. The UR improved from 53.47% (762/1425) in the pre-intervention period to 65.95% (4393/6661) in the post-intervention period (P < 0.001). NUR in "Tissue Quality" category decreased from 34.32% to 29.7% from the pre to the post-intervention period (P < 0.001). NUR in "Blood Sample Issues" category reduced from 3.23% to 0.32% from the pre to the post-intervention period (P < 0.001). NUR in "Medical History" category decreased from 5.68% to 0.33% from the pre to the post-intervention period (P < 0.001).

Conclusions: The study indicates that QAP improves UR of recovered corneas. In countries with a shortage of donor corneas, increasing utilization of recovered corneas can lead to an increase in corneal transplants. Implementation of QAP at the Eye Bank can be a means of achieving this outcome.

Keywords: Cornea transplant; Eye bank; Non-utilization rate; Quality assurance; Reasons of non-utilization; Utilization rate.