Transplante de córnea em ceratocone: avaliação dos resultados e complicações obtidos por cirurgiões experientes e em treinamento

Mascaro, Vera Lúcia Degaspare Monte; Scarpi, Marinho Jorge; Hofling-Lima, Ana Luísa; Sousa, Luciene Barbosa de

doi:10.1590/s0004-27492007000300004

Cited by 7 publications

(3 citation statements)

References 73 publications

(113 reference statements)

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“…However, although corneal transplantation is the oldest, most common and most successful form of tissue transplantation, due to the immunological privilege of the anterior chamber, rejection continues to be the biggest cause of failure in corneal transplants, even considering non-vascularised corneas such as keratoconus [21].…”

Section: Discussionmentioning

confidence: 99%

Impact of Ring Implant Surgeries on the Corneal Transplant Queue at a Reference University Hospital in the State of Pará

Guimarães,

Filho,

Oliveira

et al. 2024

JAMMR

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Keratoconus is a progressive non-inflammatory ectatic dystrophy, characterised by thinning and curving of the cornea, with central or paracentral conical protrusion, which occurs due to a biomechanical failure of the corneal stroma that is no longer able to resist the internal and external pressures exerted. The objective of the study was to analyse the positive impact of performing ring implant surgeries on patients on the corneal transplant waiting list, at the Bettina Ferro de Souza University Hospital (HUBFS), in 2023. Of the 87 intrastromal ring implants performed in 2023, 6 patients were excluded due to lack of complete data to carry out the evaluation of this work, using the total number of patients for this research 81 (100%). It was found that 89% of patients showed an improvement in corrected visual acuity after ring implantation, with approximately half reaching 100% of their visual range, providing a visual acuity of 1.0. This study showed that of the 14 patients enrolled for corneal transplantation with keratoconus who also had an indication for ring implantation, only 4 still required corneal transplantation after the procedure. In this sphere, it was evident that the patients had an improvement in visual acuity, symptoms and postponed or canceled the corneal transplant. However, more research is needed in this field, in order to obtain advances that make this procedure even safer, minimizing the risks inherent to its placement, with a view to improving the patient's quality of life.

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Section: Discussionmentioning

confidence: 99%

Impact of Ring Implant Surgeries on the Corneal Transplant Queue at a Reference University Hospital in the State of Pará

Guimarães,

Filho,

Oliveira

et al. 2024

JAMMR

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“…Surgical treatment is reserved for cases when contact lenses can no longer be fitted, become intolerable or do not provide good visual acuity (12) . Alternative surgical techniques, such as the implantation of ICRS have been developed to try to avoid or postpone penetrating keratoplasties (13) .…”

Section: Introductionmentioning

confidence: 99%

Contact lenses fitting after intracorneal ring segments implantation in keratoconus

Moreira

Bardal

Crisigiovanni³

2013

Arq. Bras. Oftalmol.

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“… 3 4 Many studies have reported the outcomes of penetrating keratoplasty procedures performed by residents during elective surgery in the OR. 5 6 7 8 9 10 11 However, a large diversity of assessment parameters has been proposed (i.e., details on surgery times, graft clarity, postoperative astigmatism, best corrected visual acuity, and graft survival), reflecting the difficulty of finding widely accepted and reproducible assessments for the quality of a given surgical procedure. Defining the optimal parameters for assessing good surgical procedures remains difficult, 12 and the corresponding objective scores for their assessment in corneal suturing still need to be determined.…”

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confidence: 99%

Resident Skills Assessment in Corneal Suturing: A Comprehensive Review of Currently Proposed Educational Programs and Evaluation Tools

Dormegny

Neumann²,

Lejay

et al. 2021

Journal of Academic Ophthalmology

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Purpose This study aimed to perform a comprehensive review of publications proposing educational programs for resident skills assessment in corneal suturing. Methods An extensive online article search in PubMed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PISMA) reporting guidelines was performed to identify prospective comparative studies or prospective before/after studies published up to March 2021 and reporting the assessment of ophthalmology residents' skills in corneal suturing during dedicated training sessions. Results Three studies were identified for review. The first reported the efficiency of an electromagnetic tracking system placed on the surgeon's fingers coupled with a computer analysis of movements and time to identify surgeons with different backgrounds in corneal suturing. The second reported the efficiency of the reference system in assessing the improvement of corneal suturing conducted by residents after a training session, with video-based assessment for economy and confidence of movement, limiting tissue damage and precision of operative technique, reviewed by blind assessors. The third proposed an innovative remote corneal suturing training method using Zoom for direct feedback to the residents. The stitch quality was assessed for length, depth, radiality, and tension. The results were similar when compared with a group of residents without feedback. Conclusion This review underlines the rarity and disparity of available tools for corneal suturing assessment, justifying the need for more complete models to be designed. These should consider body ergonomics and stitch quality and time. Comparative studies involving novices and attendings may provide reliable evaluation of existing gaps and specific metrics to target, helping residents to approach their superiors' experience.

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Transplante de córnea em ceratocone: avaliação dos resultados e complicações obtidos por cirurgiões experientes e em treinamento

Abstract: In a corneal referral practice, the visual results after PK were similar to those related to the PK performed by either expert surgeons or in training.

Cited by 7 publications

References 73 publications

Impact of Ring Implant Surgeries on the Corneal Transplant Queue at a Reference University Hospital in the State of Pará

Impact of Ring Implant Surgeries on the Corneal Transplant Queue at a Reference University Hospital in the State of Pará

Contact lenses fitting after intracorneal ring segments implantation in keratoconus

Resident Skills Assessment in Corneal Suturing: A Comprehensive Review of Currently Proposed Educational Programs and Evaluation Tools

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