FATORES ASSOCIADOS À QUALIDADE DAS CÓRNEAS CAPTADAS PARA TRANSPLANTES E SUAS RELAÇÕES COM O GRAU DE CLASSIFICAÇÃO DESTE TECIDO

Abstract

Introduction: The cornea consists of avascular, transparent, convex connective tissue with great innervation, and is divided into six layers. Corneal transplantation, or keratoplasty, is the main intervention for restoring the recipient’s visual acuity, since most underlying diseases affect the clarity of this tissue. For corneal tissue to be used for keratoplasty, its quality has to be assessed and, if it does not meet the established criteria, the tissue collected is considered unqualified for the surgical procedure. Objective: To evaluate the factors associated with the quality of corneas procured for transplantation and their relationship with the classification grade of this tissue. Method: This is an epidemiological study carried out through a retrospective cohort, based on secondary data from cornea donation forms registered with the BTOH. The population consisted of donation forms filled out by the Human Eye Tissue Bank (BTOH) between January 1, 2022 and March 31, 2024. Sampling was of a non-probabilistic census type, since information was collected from all cadaver patients, donors of corneal tissues collected by BTOH during the period. After collection and tabulation, the data were subjected to statistical analysis using Jamovi software. Descriptive and inferential analyses were performed. Results: Factors such as donor age, serology results (such as for COVID-19, HIV and HbsAg), and the presence of stromal edema, stromal infiltrate, and endothelial guttata was associated with lower corneal quality. The time between death-enucleation, death-preservation, death-dispensing, enucleation-preservation and preservation-dispensing processes did not demonstrate significant differences for the final classification of the tissue, which suggests a standardization of the processes. The hypothermic storage medium used (Optisol-GS or Eusol-C) had no significant influence on the progression of tissues initially classified as good quality to the worst quality group. The nursing team plays a fundamental role In BTOH, working in several stages, such as family interview, tissue collection, evaluation of the eyeball and initial analysis of the quality of the cornea, even performing enucleation. However, the processes in which these professionals are involved have not demonstrated an association with the final classification of the tissue for therapeutic use or disqualification. There is a tendency for tissues to receive worse scores in the second evaluation compared to the first, and this difference may be related to the tissue storage time or the subjectivity of the evaluations carried out by the professionals, since these evaluations are mostly carried out by different professionals. Conclusion: It should be highlighted that the standardization of processes and the implementation of calibration protocols among evaluators, combined with regular training, are essential strategies to reduce subjectivity and standardize evaluation criteria in BTOH. As for storage methods, cost-minimization studies are recommended to determine the product with the greatest cost-benefit. Although Optisol-GS and Eusol-C demonstrated similar efficiency in maintaining tissue quality, the low probability of Eusol-C negatively impacting corneal quality deserves attention in future economic analyses.