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Glycerol-preserved corneal tissue in emergency corneal transplantation

An alternative for fresh corneal tissue in COVID-19 crisis

Raj, Anuradha; Agrawal, Nikhil

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Indian Journal of Ophthalmology: January 2021 - Volume 69 - Issue 1 - p 169
doi: 10.4103/ijo.IJO_2223_20
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Dear Editor;

We read the article by Gupta et al. on “Glycerol-preserved corneal tissue in emergency corneal transplantation: An alternative for fresh corneal tissue in COVID-19 crisis”[1] with profound interest and want to congratulate the authors for their research work. Glycerol-preserved cornea (GPC) has important utility in emergency keratoplasty where the availability of fresh corneal tissue (FCT) is questionable in the developing world.[2] We would like to appreciate the authors for comparing the GPC and FCT in corneal transplantations. However, we would like to draw attention to clarify our concerns regarding this published article.

First of all the title of the article in unjustified as the data presented in the study does not belong to the COVID era. The whole article is not explaining anything related to the COVID era, but just a paragraph at the end cannot justify the article title. To make a statement in the title, the data should be around that time domain.

The next point lies in statistical analysis as this section mentioned about Mann-Whitney U test, t-test, and Chi-square test. However, Table 4 uses Fisher's exact test, which is not mentioned in the methodology.[1]

In the result section, it is mentioned that there was 100% graft failure in glycerol-preserved tissue. We believe that it is worth to classify graft failure in terms of primary graft failure and secondary graft failure. The authors have described retransplanting with optical grade tissues in 11 eyes in the FCT group and 5 eyes in the GPC group, but the GPC group showed graft failure in all 34 cases. The fate of the other 29 cases of graft failure is not mentioned. Besides, the authors mentioned that there was a reinfection in 11 eyes in the FCT group. It would have been informative if the management of graft infection was mentioned in terms of conservative or surgical.

Furthermore, there is repetition and duplication of data of the GPC group mentioned in results, in Table 2 and Tables 3 and 4 with a previous article published in 2017 in IJO with PMID 28724812.[3] Publishing or reusing the same dataset is considered as an overlapping publication or salami slicing.[4] In our opinion, duplication of data is wrong on ethical grounds if it is used for the same purpose for different titles.

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Conflicts of interest

There are no conflicts of interest.

1. Gupta N, Dhasmana R, Maitreya A, Badahur H. Glycerol-preserved corneal tissue in emergency corneal transplantation: An alternative for fresh corneal tissue in COVID-19 crisis Indian J Ophthalmol. 2020;68:1412–6
2. Michael RF, Geoffrey CT, Lloyd W, Matt O. The use of glycerol-preserved corneas in the developing world Middle East Afr J Ophthalmol. 2010;17:38–43
3. Gupta N, Upadhyay P. Use of glycerol-preserved corneas for corneal transplants Indian J Ophthalmol. 2017;65:569–73
4. Sarwar U, Nicolaou M. Fraud and deceit in medical research J Res Med Sci. 2012;17:1077–81
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