ICRS implantation has shown effectiveness and safety in most cases, including combined procedures. In properly selected eyes, it can improve both refraction and vision in patients with keratoconus. [J Refract Surg. 2016;32(12):829-839.].

Purpose: To describe the epidemiological profile of patients waiting for penetrating keratoplasty in state of Pernambuco, Brazil. Methods: Transversal and retrospective study, with 871 patients, in the period of 06/01/2011 a 05/31/2012, were registered on the waiting list for corneal transplantation in the Central of Notification, Captation and Distribution of Organs (CNCDO) of Pernambuco. Registration forms of cornea receiving were used, adapted to the purposes of this research. Results: In relation to frequency, it was obtained 54% female, 35% aged 61 to 80 years; 60% transplanted; 52% from the metropolitan area of Recife; 57% that waited 1 to 6 months the transplant; 82% with optical indication for transplant, 5% with priority on the waiting list (48% of those with ocular perforation) and; 37% whose transplant center was the Fundação Altino Ventura (FAV). The main indications for corneal transplantation were leukoma (33%), keratoconus (22%) e bullous keratopathy (18%). Conclusion: It was found that most patients were aged 61 to 80 years; was from the metropolitan area of Recife; was submitted to corneal transplantation; waited for one to six months to do the transplantation; had the diagnosis leukoma, followed by keratoconus and bullous keratopathy; was indicated to transplantation optical and had the transplant center to FAV.

Purpose: To analyze 15-year of corneal transplant in Brazil. Methods: Cross-sectional, retrospective, observational, and analytical study, between available data from the Brazilian Transplant Registry (January 2002–December 2016), collected by the Brazilian Association of Organ Transplantation was performed. The variables analyzed per year were number of corneal transplants, corneal transplants per million people (pmp), corneal transplant teams, and individuals on the waiting list for corneal transplants. Quantitative variables were expressed by their respective values. To verify the relationship of time with the variables, the Spearman correlation test was applied, adopting P<0.05 for rejection of the null hypothesis. Results: Evaluation of the data from 2002 to 2016 revealed an increase in number of (1) corneal transplants (4,976–14,534—approximately 292% in 15 years; P<0.0001); (2) corneal transplants pmp (29.4–71.1 pmp; P<0.0001); (3) productivity of corneal transplants teams (40.1–79 transplants by each team per year; P=0.067); (4) effectiveness in meeting the Brazilian population demand for corneal transplants per year (18.2%–57.0%; P<0.0001); (5) potential donors (P<0.0001), effective donors (P<0.0001), and nondonors (P<0.0001). There was a reduction in the number of patients on the waiting list (19,189–10,923; P=0.056). Conclusion: Despite the progress in the last decade, the number of corneal transplants in Brazil cannot meet the growing population demand. Thus, this study suggests the implementation of more effective public policies of corneal transplants in Brazil, to minimize disparities in national territory, adequately meet the population demand, and reduce the time in waiting lists for corneal transplants.

Purpose: To evaluate ophthalmological emergencies in a public reference hospital in Pernambuco. Methods: Cross-sectional retrospective study with 26.358 patients attended in the ophthalmic emergency Altino Ventura Foundation, in the period january to june 2013. Data were collected using protocols based on electronic registration forms of ophthalmological emergency Results: It was observed that 52.5% of patients were male, 42.5% were aged 21-40 years; 90.8% were from the region metropolitan area of Recife; 55% classified as less severe. The main diagnoses were conjunctivitis (35.17%) and ocular trauma (19.25%). Conclusion: The prevalence of male patients, aged 21-40 years, from the metropolitan area of Recife, classified as low complexity, attended in January, on Monday, with the diagnosis of conjunctivitis, followed by ocular trauma.

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Recebido para publicação em 13/06/2014 -Aceito para publicação em 11/07/2014 Os autores declaram não haver conflitos de interesseObjetivo: Avaliar o efeito preemptivo com nepafenaco 0,1% em pacientes submetidos à fotocoagulação da retina para tratamento da retinopatia diabética proliferativa. Métodos: Trinta pacientes foram submetidos à fotocoagulação com laser de argônio em ambos os olhos. O olho contralateral de cada paciente foi o controle. O nepafenaco e o placebo foram utilizados 30 minutos antes da aplicação do laser. Ambos os olhos foram fotocoagulados no mesmo dia. A intensidade da dor foi avaliada por meio da escala analógica visual e da escala descritiva de dor. Resultados: A análise da interação instilação versus nepafenaco mostrou que os pacientes do grupo placebo apresentaram níveis de dor semelhantes em ambos os olhos, e os do grupo nepafenaco apresentaram redução importante do nível de dor no olho em que foi instilado a suspensão de 0,1% quando comparado ao olho contralateral que recebeu placebo (p=0,023). Conclusão: Este estudo sugere que a suspensão de 0,1% de nepafenaco foi útil na analgesia preemptiva de pacientes submetidos à fotocoagulação de retina quando comparada ao placebo.Descritores: Dor/prevenção & controle; Analgesia; Anti-inflamatórios não esteroides/administração & dosagem; Anti-inflamatórios não esteroides/uso terapêutico; Fotocoagulação; Retinopatia diabética/quimioterapia ABSTRACT RESUMOObjective: To evaluate the preemptive effect of nepafenac 0,1% in patients undergoing retinal photocoagulation for the treatment of proliferative diabetic retinopathy. Methods: Thirty patients underwent argon laser photocoagulation in both eyes. The contralateral eye of each patient was the control. The nepafenac and placebo were used 30 minutes before the application of the laser. Both eyes were photocoagulated in the same day. Pain intensity was assessed by visual analog scale and descriptive pain scale. Results: The analysis of the interaction instillation versus nepafenac showed that patients in the placebo group had similar levels of pain in both eyes, and the nepafenac group had significant reduction in pain in the eye that was instilled suspension of 0,1% when compared to the contralateral eye which received placebo (p = 0.023). Conclusion: This study suggests that a suspension of 0,1% nepafenac helpful for preemptive analgesia in patients undergoing retinal photocoagulation compared to placebo.

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The aim of this study was to identify inequalities in corneal donation and transplantation among the regions of Brazil. A transversal and retrospective study was specifically conducted using data from the Brazilian Transplant Registry collected by the Brazilian Association of Organ Transplantation between January 2002 and December 2014. The collected data were processed using descriptive statistical methods, and p<0.05 was the rate of rejection of the null hypothesis. From 2002 to 2014, there was an increase in the absolute number of corneal transplants, the annual rate of transplants per million people and the percentage of needed transplants performed in each of the five regions of Brazil. Family refusal and medical contraindication were the most frequent reasons for a lack of corneal donation. Although remarkable progress has been made in the last decade in each of the five Brazilian regions, health professionals’ lack of preparation to approach families with donation requests at the death of a family member appears to be the main obstacle to increasing the number of corneal donations. Thus, the present study suggests the implementation of public policies to make corneal transplants more effective, particularly given that there are considerable disparities in the effectiveness with which regional needs are met and in health professionals’ ability to perform transplants among the Brazilian regions, with higher rates in the South, Southeast and Midwest regions and lower rates in the North and Northeast regions.