RESUMEN

PURPOSE: To identify the donors' profile and evaluate the factors influencing the quality of the donated corneas in Santa Casa Eye Bank, from July, 2000 to January, 2004. METHODS: Data from the charts of 151 patients submitted to penetrating keratoplasty, registered in Santa Casa Eye Bank, from July, 2000 to January 2004 resulted in 180 surgeries. RESULTS: Mean age of the donors was 57.57 +/- 19.74 years old (varied from 9 months to 97 years old) and 54.44% were male. The cause of death was predominantly cardiovascular (50.55%), followed by consumptive diseases (17.77%), trauma (14.44%) and others (17.22%). Considering the quality of the cornea, there was no statistically significant difference among the three main groups of cause of death (p=0.527) and time from death to corneal preservation (p=0.053). There was a statistically significant difference between quality of donated corneas above 61 years old and other ages (p=0.037). CONCLUSION: The most frequent cause of death was cardiovascular, followed by pulmonary diseases and trauma. We could also note that factors inherent to donor like age (>60 years old) predisposed to a worse anatomical quality of the cornea and factors like cause of death and time between death and preservation did not influence the quality of the cornea.

Asunto(s)

RESUMEN

Objetivo: Traçar o perfil do doador de olhos e avaliar os fatores que influenciam na qualidade das córneas captadas pelo Banco de Olhos da Santa Casa de Misericórdia de São Paulo (SCMSP), no período de junho de 2000 a janeiro de 2004. Métodos: Foram estudados os dados dos prontuários de 151 pacientes submetidos a transplante penetrante de córnea, cadastrados no Banco de Olhos da SCMSP, no período entre junho de 2000 e janeiro de 2004, totalizando 180 operações. Resultados: A média da idade dos doadores foi de 55,57 ± 19,74 anos (variando de 9 meses a 97 anos de idade), sendo 54,44 por cento dos pacientes do sexo masculino. As causas mortis predominantes foram as cardiovasculares, com 50,55 por cento, seguidas das doenças consumptivas 17,77 por cento, traumáticas 14,44 por cento e outras, que somadas representam 17,22 por cento. Em relação à qualidade da córnea, não houve diferença estatística significativa em relação aos quatro grupos causas mortis p=0,527), e o tempo decorrido entre o óbito e a preservação (p=0,053). Houve diferença estatisticamente significativa entre a qualidade das córneas de doadores da faixa etária acima de 61 anos de idade em relação às outras faixas etárias (p= 0,037). Conclusão: As causas mortis mais frequentes foram as cardiovasculares, seguidas das causas pulmonares, outras e traumáticas. Observamos também que entre os fatores inerentes ao doador, a faixa etária acima de 60 anos, predispôs à pior qualidade anatômica das córneas, e fatores como a causa mortis e o tempo decorrido entre o óbito e a preservação, não influenciaram na qualidade das mesmas.

Purpose: To identify the donors' profile and evaluate the factors influencing the quality of the donated corneas in Santa Casa Eye Bank, from July, 2000 to January, 2004. Methods: Data from the charts of 151 patients submitted to penetrating keratoplasty, registered in Santa Casa Eye Bank, from July, 2000 to January 2004 resulted in 180 surgeries. Results: Mean age of the donors was 57.57 ± 19.74 years old (varied from 9 months to 97 years old) and 54.44 percent were male. The cause of death was predominantly cardiovascular (50.55 percent), followed by consumptive diseases (17.77 percent), trauma (14.44 percent) and others (17.22 percent). Considering the quality of the cornea, there was no statistically significant difference among the three main groups of cause of death (p=0.527) and time from death to corneal preservation (p=0.053). There was a statistically significant difference between quality of donated corneas above 61 years old and other ages (p=0.037). Conclusion: The most frequent cause of death was cardiovascular, followed by pulmonary diseases and trauma. We could also note that factors inherent to donor like age (>60 years old) predisposed to a worse anatomical quality of the cornea and factors like cause of death and time between death and preservation did not influence the quality of the cornea.

Asunto(s)

RESUMEN

PURPOSE: Retinal photocoagulation under poor visualization condition is often required. Transscleral infrared laser can be used as an alternative to regular transpupillary treatment. Based upon retinographic measurements, we proposed to estimate the reproducibility as well as ocular wall permeability rate for this treatment. Our primary goal was to evaluate whether this technique can deliver adequate photocoagulation at predetermined parameters without direct retinal visualization. METHODS: In New Zealand pigmented rabbits, optimal transscleral infrared diode laser settings were administered to the right eye. With the same parameters, transpupillary photocoagulation was repeated in the left eye. Retinographic and clinical examinations were performed immediately and two months later. RESULTS: Ocular wall permeability rate varied between 58.95 and 63.87%. Average permeability using a power of 300 mW (63.14%) was found to be higher than that encountered before its enhancement up to 500 mW (59.11%), (P<0.05). CONCLUSIONS: Setting parameters showed dose-response effect. No retinal hole or retinal detachment was noticed in any rabbit. Transscleral infrared photocoagulation appeared to be a reproducible and secure method in the experimental model.

Asunto(s)

RESUMEN

PURPOSE: To identify the indications for penetrating keratoplasty at the Department of Ophthalmology of the Santa Casa of São Paulo from January 1996 to December 2005 and to compare them with those from January 1991 to December 1995. METHODS: Charts of patients who had undergone penetrating keratoplasty from January 1996 to December 2006 were retrospectively reviewed. RESULTS: There were 587 keratoplasties done in this period. The average age of patients was 49.6 +/- 21.1 years (range 1 to 91 years). The most common indications were infectious keratitis (17.9%), trauma (16%), pseudophakic bullous keratopathy (14.7%), keratoconus (13.1%), regrafts (12.8%) and herpetic keratitis (6.6%). CONCLUSION: The leading indications for penetrating keratoplasty were infectious keratitis, trauma, bullous keratopathy, herpetic keratitis. There was a decreasing trend in penetrating keratoplasty for keratoconus and regraft during the last 10 years.

Asunto(s)

RESUMEN

OBJETIVOS: Pesquisa experimental, com laser de diodo infravermelho, para estimar a segurança, a reprodutibilidade e a permeabilidade da parede ocular à sua atuação clínica, quando aplicado via transescleral, em condições de baixa visibilidade. MÉTODOS: Submetemos olhos de coelhos pigmentados da raça Nova Zelândia à fotocoagulação retiniana por laser de diodo infravermelho. No olho direito, realizamos fotocoagulação via transescleral sob parâmetros de potência e tempo pré-determinados clinicamente. No olho esquerdo, foram repetidos os mesmos valores da potência e tempo usados no olho direito, desta vez, via transpupilar. Imediatamente e após 2 meses, estudos clínicos baseados na retinografia e histopatológicos foram realizados. RESULTADOS: A permeabilidade da parede ocular, quando da aplicação do laser de diodo infravermelho via transescleral, variou entre 58,95 e 63,87 por cento. A média da permeabilidade da parede ocular a 300 mW (63,14 por cento) mostrou-se significativamente superior àquela da permeabilidade da parede ocular encontrada a 500 mW (59,11 por cento), (P<0,05). CONCLUSÕES: Este estudo sugere a existência da relação dose-resposta em relação aos parâmetros empregados na aplicação do laser de diodo infravermelho via transescleral, com permeabilidade da parede ocular mensurável e reprodutível. Nenhuma rotura, hemorragia ou descolamento da retina ou vítreo foi constatado aos exames subseqüentes às aplicações do laser de diodo infravermelho, o que torna o uso da fotocoagulação via transescleral, no modelo experimental, seguro, mesmo sob condições de baixa visibilidade dos meios.

PURPOSE: Retinal photocoagulation under poor visualization condition is often required. Transscleral infrared laser can be used as an alternative to regular transpupillary treatment. Based upon retinographic measurements, we proposed to estimate the reproducibility as well as ocular wall permeability rate for this treatment. Our primary goal was to evaluate whether this technique can deliver adequate photocoagulation at predetermined parameters without direct retinal visualization. METHODS: In New Zealand pigmented rabbits, optimal transscleral infrared diode laser settings were administered to the right eye. With the same parameters, transpupillary photocoagulation was repeated in the left eye. Retinographic and clinical examinations were performed immediately and two months later. RESULTS: Ocular wall permeability rate varied between 58.95 and 63.87 percent. Average permeability using a power of 300 mW (63.14 percent) was found to be higher than that encountered before its enhancement up to 500 mW (59.11 percent), (P<0.05). CONCLUSIONS: Setting parameters showed dose-response effect. No retinal hole or retinal detachment was noticed in any rabbit. Transscleral infrared photocoagulation appeared to be a reproducible and secure method in the experimental model.

Asunto(s)

RESUMEN

OBJETIVO: Determinar as principais indicações de transplante penetrante de córnea no Departamento de Oftalmologia da Irmandade da Santa Casa de Misericórdia de São Paulo nos pacientes operados no período de janeiro de 1996 a dezembro de 2005 e compará-las com os dados obtidos entre janeiro de 1991 e dezembro de 1995. MÉTODOS: Realizado estudo retrospectivo dos prontuários de pacientes submetidos a transplante penetrante de córnea no período de janeiro de 1996 a dezembro de 2005. Para comparação dos resultados utilizamos o estudo realizado no nosso serviço em 1998. RESULTADOS: Quinhentos e oitenta e sete transplantes penetrantes de córnea foram realizados no período de janeiro de 1996 a dezembro de 2005. A idade média dos pacientes foi de 49,6 anos e variou de 1 a 91 anos. As principais indicações de transplante penetrante de córnea foram ceratite infecciosa (17,9 por cento), trauma (16 por cento), ceratopatia bolhosa do pseudofácico (14,7 por cento), ceratocone (13,1 por cento), reoperação (12,8 por cento) e herpes (6,6 por cento). CONCLUSÃO: Houve aumento nas indicações de transplante penetrante de córnea nos últimos 10 anos nos casos de ceratite infecciosa, trauma, ceratopatia bolhosa do pseudofácico e herpes e diminuição nos de ceratocone e reoperação.

PURPOSE: To identify the indications for penetrating keratoplasty at the Department of Ophthalmology of the Santa Casa of São Paulo from January 1996 to December 2005 and to compare them with those from January 1991 to December 1995. METHODS: Charts of patients who had undergone penetrating keratoplasty from January 1996 to December 2006 were retrospectively reviewed. RESULTS: There were 587 keratoplasties done in this period. The average age of patients was 49.6 ± 21.1 years (range 1 to 91 years). The most common indications were infectious keratitis (17.9 percent), trauma (16 percent), pseudophakic bullous keratopathy (14.7 percent), keratoconus (13.1 percent), regrafts (12.8 percent) and herpetic keratitis (6.6 percent). CONCLUSION: The leading indications for penetrating keratoplasty were infectious keratitis, trauma, bullous keratopathy, herpetic keratitis. There was a decreasing trend in penetrating keratoplasty for keratoconus and regraft during the last 10 years.

Asunto(s)