Search Results

Abstract

Objetivo: Reportar sobre os primeiros três anos do Centro de Oncologia Ocular do Amazonas, primeiro centro de oncologia ocular na região Norte do Brasil.
Métodos: Relatamos informações de diagnóstico, idade, sexo, tratamento e cidade de origem dos pacientes atendidos nos 3 primeiros anos.
Resultados: Identificamos 221 pacientes, dos quais 160 (72%) eram da cidade de Manaus, 52 (24%) de outras cidades do Amazonas e 9 (4%) de outros estados. Dos 221 casos, 150 (68%) eram lesões benignas e 71 (32%) malignas. Lesões benignas incluíram pterígio, calázio, nevus e papiloma de conjuntiva, catarata e descolamento de retina. Das lesões malignas a mais comum foi o carcinoma escamoso de conjuntiva com 43 casos (60%). Outros diagnósticos incluíram melanoma de coróide (8 casos, 11%), retinoblastoma (7 casos, 9%), linfomas (5 casos, 7%), carcinoma da pálpebra (4 casos, 5%), melanoma da conjunctiva (2 casos, 2%) e sarcoma de Kaposi (1 caso, 1%). Dentre os CEC de conjuntiva, a idade media foi de 62 anos e 30 pacientes (69%) eram do sexo masculino. Vinte e nove casos (67%) foram tratados com biópsia excisional e 14 (33%) com quimioterapia tópica neoadjuvante seguida de cirurgia.

Keywords: Olho/patologia; Neoplasias oculares; Carcinoma; Melanoma; Oncologia; Amazonas

Abstract

PURPOSE: To determine the indications and epidemiological characteristics of corneal transplant recipients at a referral center in Amazonas, Brazil, and to evaluate postoperative visual outcomes.
METHODS: This retrospective, descriptive, observational study included adult patients who underwent corneal transplantation performed by a single surgeon at the Instituto de Oftalmologia de Manaus between 2013 and 2023. Demographic characteristics, occupation, comorbidities, surgical indications, graft type, and best-corrected visual acuity at baseline and 12 months postoperatively were analyzed.
RESULTS: A total of 413 corneal transplantations were performed, predominantly in male patients (64.4%) aged 41–70 years (43.3%). Leucoma was the most common indication (26.2%), followed by perforated corneal ulcers (21.1%), bullous keratopathy (17.9%), and keratoconus (10.7%). Penetrating keratoplasty accounted for 94.9% of all procedures. Optical keratoplasty was the most frequently performed procedure (76.3%), followed by tectonic (22.0%) and therapeutic (1.7%) keratoplasty. At 12 months postoperatively, visual improvement was greatest among patients who underwent optical keratoplasty, particularly those with keratoconus, bullous keratopathy, and leucoma. Functional vision (≤0.3 logMAR) was achieved in 32.6% of eyes overall and in 40.3% of eyes that underwent optical keratoplasty. The number of transplantations declined after 2019, coinciding with the COVID-19 pandemic.
CONCLUSIONS: This study represents the largest retrospective series of corneal transplantations in Amazonas and one of the few such studies from Northern Brazil. The predominance of leucoma and infectious corneal perforation reflects regional socioeconomic and occupational vulnerabilities. Although visual outcomes improved significantly after transplantation, visual recovery was limited by the advanced stage of disease at presentation. These findings underscore the need to expand access to early diagnosis, strengthen eye banking and donor tissue procurement systems, and increase the adoption of lamellar keratoplasty techniques to optimize visual outcomes in the Amazon region.

Keywords: Corneal transplantation; Corneal opacity; Eye infections; Keratoplasty; Epidemiology; Visual acuity; Amazonas; Brazil