ANÁLISE DOS ASPECTOS CLÍNICOS E EPIDEMIOLÓGICOS DE PACIENTES RETRANSPLANTADOS COM CÓRNEAS

Abstract

Corneal transplantation represents the possibility of recovery of vision and consequent improvement in the quality of life of those affected by various conditions that can partially impair vision or even cause blindness. It deals with the most performed transplant procedure in the world, widespread in countries with the most diverse structures for its viability, with varying success rates. Although it is a procedure that has several scientific studies for its improvement and that values the safety of the patient submitted to it, it is subject to failures and can greatly impact the lives of those who underwent an initial corneal transplant and need to redo it. The objective of this study was to analyze clinically and epidemiologically the patients who were re-transplanted with corneas. It is an epidemiological study with a quantitative approach, with a transversal, individualized, analytical design, based on secondary data from patients who underwent corneal retransplantation in Mato Grosso do Sul, from January 2014 to December 2018. The sample was census, constituted by patients with previous corneal transplant failure. We included all patients who were re-transplanted with corneas. The research protocol was approved by the Research Ethics Committee of the Federal University of Mato Grosso do Sul under opinion no. 3,177,423. Data were collected from January to June 2019 using a collection instrument used in a study previously and adapted for the purposes of this study. The data were submitted to statistical analysis using the free statistical software R, version 3.0.0. For the description of the variables and their distribution patterns, the frequencies and measures of central tendency and dispersion were established. For multivariate analysis, measures of effect and association magnitude were applied, according to each variable under analysis. Of the total of 823 corneal transplant patients in the studied period, 4.98% had primary or secondary graft failure with previous transplant failure, requiring retransplantation. Of the re-transplanted patients, 51.22% were female, 70.73% aged over 50 years and 51.22% residing in the state capital. The average age of the re-transplanted recipients was 62.07 years (± 14.54), while the sizes of the donor and recipient corneal buttons had an average value of 8.10 mm ± 0.28 and 7.95 mm ± 0.43, respectively, with 68.29% of the donor buds' size larger than that of the re-transplanted recipients. The analysis identified a profile of patients over the age of 50 and living in the state capital. Primary failure was the main type of corneal graft failure found in patients. Vascularization was present in 53.66% of patients and 99.24% underwent previous eye surgery, in addition to keratoplasty. Of the patients who composed the sample, 70.17% had pseudophakic eyes, with a predominance of penetrating surgical technique. The most evident surgical purpose was optical in 97.56% of the patients and elective in 85.37% of the cases. The rate of retransplantation in this study is as expected and in line with other studies carried out in the country and in the world.