Abstract
Purpose: :
To analyze the diagnostic categories of patients with corneal transplants in Mexico.
Methods: :
Retrospective analysis of the entire National Transplant Registry from 1992 to May 2010. Only patients that were grafted were included in the analysis. Age, sex, diagnosis, region of the country and type of health service (private or public) were studied. For continuous variables, and according to their distribution, mean and standard deviation or median and confidence intervals (95%) were tested with T-Student and Kruskal Wallis test respectively. A multiple logistic regression was performed to determine the odds ratio (OR) as a measurement for the possibility of being grafted among the different diagnostic categories in the database. Statistical analysis was performed using STATA 9 (Stata Corp., College Station, Tex).
Results: :
27825 patients (15387 men and 12438 women) were initially included for analysis. 11,102 were excluded as they did not receive tissue for transplantation, and therefore remained ungrafted. 16723 patients were analyzed , of which 73.34% of them were performed in the period from 2005-2010. The most frequent diagnostic category for surgery was corneal ecatsia (7699 cases, 45.86%), followed by bullous keratopathy, (4071 cases, 24.34%). "Other causes" followed with (3290 cases, 21.38%). Logistic regression analysis revealed that corneal degenerations had a OR 11.07 (CI95% 2.52-48.55), followed by bullous keratopathy (4.69 [CI95% 4.31-5.11]), and trauma (4.81 [CI95% 3.49-6.61); all were statistically significant with p ≤0.001. The time interval from admission to transplantation was shortest for primary endotheliopathy and longest for microbial keratitis (39 months vs 365 months p<0.05).
Conclusions: :
The most frequent diagnostic category receiving corneal transplantation was corneal ectasia followed by bullous keratopathy. However, the possibility of being grafted was higher among those with corneal degenerations, bullouskerathopaty and corneal trauma. The range of waiting time may reflect the socioeconomic status as those with microbial keratitis sequelae living in underprivileged rural areas may not benefit from health services
Keywords: cornea: clinical science • transplantation • clinical (human) or epidemiologic studies: prevalence/incidence