Abstract
Purpose :
Changing trends in the indications for keratoplasty have been reported in various studies from different countries. The purpose of this study consists in verifying a possible trend in the indications for corneal transplantation in Brazil, considering the availability of new diagnostic methods, new therapeutic approaches for corneal diseases with potential indication for keratoplasty as well as the development of new techniques of this type of surgery.
Methods :
This review was based on the data available at the National System of Transplantation, Ministry of Health, Brazil, considering that every corneal transplantation performed in the country must necessarily be reported to the government, as defined by federal legislation. The analysis considered the totality of corneal transplants reported from 2012 to 2017, considering the reported diagnosis and comparing the evolution during these years.
Results :
The absolut number of transplants in the period consisted of a total of 87.240 corneal transplants, and an increase in the annual numbers was observed since 2014. The main indications were keratoconus (25.702 patients, 29.5% of the total), bullous keratopathy (15.614 patients, 17.9% of the total) and Fuchs endothelial distrophy (4.915 patients, 5.6% of the total). There was a decrease in the number and proportion of patients submitted to corneal transplantation due to keratoconus and an increase in the number and proportion of patients submitted to the surgery due to bullous keratoplasty and Fuchs endothelial distrophy.
Conclusions :
It was observed a change in the trend of diagnosis for corneal transplantation in Brazil in the studied period, probably related to the availability of new diagnostic methods and therapeutic approaches to corneal diseases like keratoconus and also to the availability of new techniques for keratoplasty. Lamelar corneal transplantation, both anterior and posterior in various techniques developed in recent years, allowing safer surgeries allied to faster and better restoration of vision, certainly play a significant role in the trend identified in this study.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.