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Aida Jimenez-Corona, Alejandro Claros, Arturo Ramirez-Miranda, Alejandro Navas, Tito Ramirez-Luquín, Victor Boullosa, Enrique Graue-Hernández; Corneal Transplantation in Mexico: Future Perspectives. Invest. Ophthalmol. Vis. Sci. 2013;54(15):872.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze the current trends of corneal transplantation in Mexico and to predict corneal transplantation necessity and diagnostic for 2050
Methods: The National Transplant Registry contains all the available information about cornea transplant in Mexico. We performed a retrospective analysis of the entire dataset from October 1994 to May 31, 2010 (28,749 registries). Diagnoses were reclassified according to the EBAA classification (1993). All registries available in the database with information on whether the patient had received or not a graft were included. Using data from 2005 to 2009 from the National Graft Registry and information from the National Population Council, we calculated incident cases and rate of corneal transplantation for years 2020, 2030, 2040 and 2050. Finally, to calculate the number of expected grafts, we considered the median age and interquartile range (IQR) at the time of transplantation together with life expectancy at birth. Statistical analysis was performed with STATA 9.
Results: The sample included 27,825 subjects (15,387 and 12,438 women). Mean age was 44.5 years in men and 50.5 years in women (p<0.001). To cover annual needs in year 2020 a total of 6,139 corneal transplants would need to be performed, with a rate transplantation of 5.3 per 100,000 inhabitants. For year 2050 this number would increase to 11,127 corneal transplants with a rate transplantation of 9.1 per 100,000 inhabitants. For bullous kertopathy, the median age for corneal transplantation in 2005 was 45.2 years. Considering a median of graft survival of 8 years, 50% of patients would need at least 2 procedures in their lifetime (IQR 0-5). For keratoconus patients with a median age of 45 in 2005 and a median graft survival of 19 years, a regraft would be required at least once (IQR 0-2) in their lifetime.
Conclusion: The epidemiological profile of corneal blindness can change significantly in the following decades; therefore, adequate policies and resources need to be allocated to corneal transplant and eye banking programs. Corneal transplantation must thus be considered as a public health priority.
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