Matilde Mora, María Cristina Cortés, María Camila Plata, Daniel Suárez Acosta Pan Am J Ophthalmol 2021, 3:39 (26 November 2021) DOI:10.4103/pajo.pajo_108_21
Purpose: To describe the characteristics of the donor and recipient, indications, surgical techniques, and survival results obtained from patients with corneal transplants performed at Fundación Oftalmológica Nacional (FUNDONAL) between 2010 and 2017.
Methods: Descriptive, observational study. Medical records of patients who underwent corneal transplantation were reviewed. Demographic data, surgery indication, transplantation technique, graft transparency, and presence of rejection are evaluated. Statistical analysis was performed with the SPSS software version 21.0.
Results: Seven hundred and twelve eyes from 690 patients who underwent corneal transplantation were analyzed. The median age of the recipient was 42 years (interquartile range 21.8 years) and 392 participants (56.8%) were men. Corneal ectasias was the first indication for transplantation. The technique performed most often was penetrating keratoplasty (PK) (89.6%), followed by deep anterior lamellar keratoplasty (5.3%), endothelial keratoplasty (3.5%), and sclerokeratoplasty (1.5%). 22.25% of the cases presented at least one rejection episode. Transparency of the graft is >80% up to 36 months from follow-up.
Conclusions: In 712 eyes that underwent corneal transplantation between 2010 and 2017, the most frequent indications were corneal ectasias, pseudophakic/aphakic bullous keratopathy, and previous graft failure. Although the most common technique is PK, there is a tendency to perform more lamellar transplants over the years. Survival up to the last control was 78% with graft rejection at 22.23%, which are comparable with results reported in the scientific literature. This study constitutes the first corneal transplant registry in Colombia, with survival results and description of variables that will allow for the identification of risk factors for undesirable outcomes.
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Sila Bal, Sarah Marjane, Carlos Gonzalez, Zachary Smith, Charlene Higgins, Lucy Miller-Suchet, Gil Binenbaum Pan Am J Ophthalmol 2021, 3:38 (26 November 2021) DOI:10.4103/pajo.pajo_105_21
Background: Pterygium is an ocular surface lesion that causes chronic eye irritation and eventually, vision impairment. Pathologically, prolonged ultraviolet (UV)-induced radiation damage leads to conjunctival and limbal stem cell damage. As such, rural, high-altitude equatorial communities are at particular risk due to proximity to the sun, outdoor work, and a lack of access to eye care.
Methods: We conducted a cross-sectional study to determine the epidemiology of pterygium in the Chimborazo region of Ecuador. Adults presenting to Clinical FIBUSPAM's medical clinics for both ocular and nonocular reasons were examined by optometrists/ophthalmologists to identify pterygium. Affected patients completed a questionnaire about self-reported known risk factors, treatment, and barriers to care, and received UV-blocking sunglasses.
Results: Of 296 patients, 165 (55%) had pterygium. The mean age was 60.2 years (range 19–88), 69% were female; 63% had unilateral pterygia, and 37% had bilateral pterygia. Symptoms occurring daily included severe photophobia (36%), foreign body sensation (28%), eye pain (24%), burning (31%), and itching (28%). In addition, 40% reported concern about eye appearance. Risk factors included spending >5 h outdoors each day working (93%), smoking (8%), and alcohol (14%). For prophylaxis, while 91% routinely wore hats outdoors, only 16% used sunglasses. For treatment, 30% used eye drops, of which two-thirds were natural remedies. About 93% wanted treatment (medications or surgical removal), 78% were concerned about access to treatment, and 43% reported cost as the major concern.
Conclusions: Pterygium is highly prevalent (55%) among adults presenting for care in community health clinics in the Chimborazo Province of Ecuador. This treatable and potentially preventable cause of ocular irritation and vision loss greatly impacts the quality of life in this region. This and similar communities would benefit from improved education and outreach through care delivery models that bring affordable prevention and eye care services closer to home.
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