1. Cecilia M Cavalcanti Roberta Ventura Bernardo M Cavalcanti Ronald F Cavalcanti Demographic Profile of Corneal Transplantation patients over the past 20 years at a Northeast Brazil Eye Hospital The authors have no financial interest in the subject matter of this poster

2. Demographic Profile of Corneal Transplantation patients over the past 20 years at a Northeast Brazil Eye Hospital First successful human corneal transplant, was in 1905, done by Dr. Eduard Zirm. Although corneal transplantation remains the mainstay of surgical treatment of corneal blindness, indications for transplantation in developed and developing nations differ according to the diffrent spectrum of corneal disease in each country. Visual results and graft survival have improved over the years in several reports. The present study is a 20-year retrospective study of 2.343 corneal transplants performed in patients from Northeast at HOPE ( Hospital de Olhos de Pernambuco) and FAV (Fundação Altino Ventura). Demographic profile (gender, residency and age), leading causes and indications, visual acuity results, re-graft rates and post-operative visits are reported. Cecilia M Cavalcanti, Ventura R, Cavalcanti BM, Cavalcanti RF Introduction Purpose

3. Demographic Profile of Corneal Transplantation patients over the past 20 years at a Northeast Brazil Eye Hospital Cecilia M Cavalcanti, Ventura R, Cavalcanti BM, Cavalcanti RF Material and Methods A retrospective study was done. Data was obteined from patients chart, demographic profile, leading causes (bullous keratoplasty, keratoconus, leucoma and others - trauma, corneal perforation, corneal meelting, keratoglobus, failure and corneal ulcer). Visual acuity was reported as presenting visual acuity and re-graft rates were recorded. Post-operative visits were considered as eye examinations at the corneal department (were excluded the emergency visits or eye complementary examination).

4. Demographic Profile of Corneal Transplantation patients over the past 20 years at a Northeast Brazil Eye Hospital Cecilia M Cavalcanti, Ventura R, Cavalcanti BM, Cavalcanti RF Results Gender: males 54% and females 46%. Average age: 50,3 years. Residency: urban 63% and rural area 37%. State procedence: Pernambuco 96 % and other States 4%. 41% 29% 12% 18% Others cause include: trauma, ulcer, corneal perforation, keratoglobus and graft failure

5. Demographic Profile of Corneal Transplantation patients over the past 20 years at a Northeast Brazil Eye Hospital Cecilia M Cavalcanti, Ventura R, Cavalcanti BM, Cavalcanti RF Results Re-graft rates – 17.6% Average of post-operative visits – 29 (per transplant) with a mean follow-up of 9,3 years 28% 20% 15% 10% 12% 9% 6%

6. Demographic Profile of Corneal Transplantation patients over the past 20 years at a Northeast Brazil Eye Hospital Cecilia M Cavalcanti, Ventura R, Cavalcanti BM, Cavalcanti RF Results Indications of Cornea Transplants (5 years time line)

7. Demographic Profile of Corneal Transplantation patients over the past 20 years at a Northeast Brazil Eye Hospital Cecilia M Cavalcanti, Ventura R, Cavalcanti BM, Cavalcanti RF Discussion The long-term outcome for the optical indications showed a trend to endotelium related problems over the time line groups. This related factor is similar to other studies, as the Asian Eyes study and the West study. This could be explained by the phacoemulsification surgeries. Tectonic transplants for corneal infections and perforation are a significant percentage of corneal transplantation. However, the re-graft rates are higher than in optical treatments. The poor prognosis in terms of graft survival in tectonic corneal transplants can be explained by the severity of the indications and in some cases the delay in treatments.

8. Demographic Profile of Corneal Transplantation patients over the past 20 years at a Northeast Brazil Eye Hospital Cecilia M Cavalcanti, Ventura R, Cavalcanti BM, Cavalcanti RF Discussion Keratoconus indications have been decreasing over the years, possibily due to new treatment options as: newer contact lenses, intra-estromal rings and crosslinking therapy. Re-grafts rates showed a 17%. However it is important to remember that many corneal transplants that fail do not go for re-graft, so the graft survival rates are lower than 83%. Some studies showed a 50% of graft failure over ten years.

9. Demographic Profile of Corneal Transplantation patients over the past 20 years at a Northeast Brazil Eye Hospital Cecilia M Cavalcanti, Ventura R, Cavalcanti BM, Cavalcanti RF References 1- Moffatt SL, Cartwright VA. Stumpf TH. Centennial review of corneal transplantation. Clinical and Experimental Ophthalmology 2005, 33:642-657 2- Tan DTH, Janardhanan P, Zhou Huijun et all. Penetrating Keratoplasty in Asian Eyes. Singapore Cornel Transplant Study. Ophthalmology 2008; 115:975-982 3- Pramanik S, Musch DC, Sutphin J, Farjo AA. Extended long-term outcomes of penetrating keratoplasty for keratoconus. Ophthalmology 2006; 113:1633-1638 4- Mendes F, Schaumberg DA, Navon S, Steinert R, Sugar J, Holland EJ, Dana R. Assessment of visual Function after corneal transplantation : the Quality of Life and psychometric assessment after corneal transplantation (Q-PACT) Study.American Journal of Ophthalmology 2003, june ; 785-790 5- Patel HY, Osmonde S, Brookes NH, Moffatt LS, McGhee CNJ. The indications and outcomes of pediatric corneal transplantation in NewZeland: 1991-2003, Br J Ophthalmol 2005; 89:404-408