Effects of whole globe enucleation versus in situ corneoscleral excision on donor cornea tissue quality: a systematic review protocol

The objective of this review is to systemically compare the effects of whole globe enucleation versus in situ corneoscleral excision on donor cornea tissue quality.

Corneal transplantation serves as a sight-restoring surgery for corneal diseases, but the treatment is limited by the persistent shortage of donor corneas globally. Whole globe enucleation and in situ corneoscleral excision are the two methods for eye retrieval. Although studies have reported a higher acceptance rate for corneal donation among donors' relatives with in situ corneoscleral excision than whole globe enucleation, there are concerns regarding the impact on donor cornea tissue quality with in situ corneoscleral excision. Currently, there is limited high-quality evidence comparing the two methods.

We will consider prospective and retrospective comparative studies that examine the effects of whole globe enucleation and in situ corneoscleral excision on donor cornea tissue quality. There will be no restrictions on the recipients' characteristics, including age, sex, ocular comorbidities, or potential visual acuity after corneal transplantation.

Electronic databases, including (but not limited to) MEDLINE, Embase, Cochrane CENTRAL, ClinicalTrials,gov, and ISRCTN registry will be searched, with no restriction to the language used or date of publication. Retrieval of full-text studies, assessment of methodological quality, and data extraction will be performed independently by two reviewers. A meta-analysis, using fixed or random effects, will be performed for the included randomized controlled trials when there are sufficient similarities in the reporting of outcome measures. If meta-analysis is not possible, the pre-specified outcomes will be narratively synthesized.

PROSPERO (CRD42020210575).