Abstracts
The corneal transplantation (CT) is the most commonly performed type of transplant in the world and the Eye Banks are organizations whose capture, evaluate, preserve, store and distribute ocular tissues. With the evolution of surgical techniques and equipment for CT, the BOs had to evolve to keep up with these requirements. This evolution goes from tissues capture techniques, donating money and clarification to the patient (e.g. internet-based), use of current equipment for more adequate tissues supply for the most current surgical techniques, integration of BOs of certain country and real-time management of stocks of ocular tissues, and adequacy of laws that manage the entire process. This review aims to make a comparative review between the updated models of Brazilian, United Kingdon and American Eye Banks. Like, check what the trend towards lamellar transplants in these three countries.
Cornea; Corneal transplantation; Laser; Health services administration; Benchmarking; Brazil; United States
O transplante de córnea (CT) é o tipo de transplante mais realizado no mundo e os Bancos de Olhos (BO) são organizações que capturam, evoluem, preservam, guardam e distribuem tecidos oculares. Com a evolução das técnicas cirúrgicas e equipamentos para o CT, os BOs precisaram evoluir para acompanhar estas necessidades. Esta evolução vai desde técnicas de captura de tecidos; doação de dinheiro e esclarecimento ao paciente (baseadas na internet, por exemplo); utilização de equipamentos modernos, para fornecimento mais adequado de tecidos para técnicas cirúrgicas mais atualizadas; integração dos BOs de determinado país e gerenciamento em tempo real dos estoques de tecidos oculares, e adequação das leis que gerem todo este processo. Esta revisão tem como objetivo fazer uma comparação dos modelos atualizados de BOs brasileiro, inglês e americano, além de avaliar a tendência dos tipos de CT nestes países e sugerir melhorias ao modelo de BO brasileiro.
Córnea; Transplante de córnea; Laser; Administração de serviços de saúde; Benchmarking ; Brasil; Estados Unidos
INTRODUCTION
Eye Banks
The Eye Banks are nonprofit organizations whose capture, evaluate, preserve, store and distribute ocular tissues. Anywhere in the world through local legislation, these organizations were created, are regulated and inspected.
Lamellar Transplants
The lamellar transplantation (LT) was first performed by Von Hippel in
1888(11 von Hippel A. Eine neue Methode der Hornhauttransplantation.
Albrecht Von Graefes Arch Ophthalmol. 1888;34(1):108-30.). This
technique is more difficult to do and used to provide less visual acuity than
the penetrant keratoplasty (PK). For these reasons, especially, the LT until
about a decade ago, was done mostly for tectonic and/or cosmetics purposes, and
the PK used for optical purposes, where wanted best final visual acuity, even if
the patient needed to replace only part of the cornea, anterior or
posterior(22 Reinhart WJ, Musch DC, Jacobs DS, Lee WB, Kaufman SC, Shtein RM.
Deep anterior lamellar keratoplasty as an alternative to penetrating
keratoplasty a report by the american academy of ophthalmology. Ophthalmology.
2011;118(1):209-18.).
With the development of Eye Banks, surgical techniques and equipment as the
artificial anterior chamber, microkeratome and femtosecond lasers, LT was more
refined and technically reproducible, thus getting significant improvement in
final visual acuity(22 Reinhart WJ, Musch DC, Jacobs DS, Lee WB, Kaufman SC, Shtein RM.
Deep anterior lamellar keratoplasty as an alternative to penetrating
keratoplasty a report by the american academy of ophthalmology. Ophthalmology.
2011;118(1):209-18.
3 Lee WB, Jacobs DS, Musch DC, Kaufman SC, Reinhart WJ, Shtein RM.
Descemet's stripping endothelial keratoplasty: safety and outcomes: a report by
the American Academy of Ophthalmology. Ophthalmology. 2009;116(9):1818-30.
Review.
4 Baptista GV. Método de avaliação da qualidade de corte na confecção
de lamela corneana pediculada por microcerátomo em laser in situ ceratomileusis
[tese]. Ribeirão Preto: Universidade de São Paulo; 2005.
5 Behrens A, Dolorico AM, Kara DT, Novick LH, McDonnell PJ, Chao LC,
et al. Precision and accuracy of an artificial anterior chamber system in
obtaining corneal lenticules for lamellar keratoplasty. J Cataract Refract Surg.
2001;27(10):1679-87.
6 Springs CL, Joseph MA, Odom JV, Wiley LA. Predictability of donor
lamellar graft diameter and thickness in an artificial anterior cham-ber system.
Cornea. 2002;21(7):696-9.
7 Victor G, Faria e Sousa SJ,Alves MR, Nosé W. [MALKS: specifications
and development]. Arq Bras Oftalmol. 2006;69(2):151-5.
8 Victor G, Sousa SJ, Alves MR, Nosé W. Evaluation of a new system for
obtaining donor lamellar grafts. Cornea. 2007;26(2):151-3.
9 Keenan TD, Jones MN, Rushton S, Carley FM; National Health Service
Blood and Transplant Ocular Tissue Advisory Group and Contributing
Ophthalmologists (Ocular Tissue Advisory Group Audit Study 8).Trends in the
indications for corneal graft surgery in the United Kingdom: 1999 through 2009.
Arch Ophthalmol. 2012;130(5):621-8.-1010 Eye Bank Association of America. 2012 Banking statiscal report
[Internet]. Washington, DC: Eye Bank Association of America; 2013 [cited 2013
Feb 10].Available from:
http://www.restoresight.org/wp-content/uploads/2013/04/2012_Statistical_Report_FINAL-reduced-size-4-10.pdf
http://www.restoresight.org/wp-content/u...
).
Thus, LT (anterior or posterior) is becoming the technique of choice in
conditions in which it is only necessary to exchange a part of the cornea
(anterior or posterior)(22 Reinhart WJ, Musch DC, Jacobs DS, Lee WB, Kaufman SC, Shtein RM.
Deep anterior lamellar keratoplasty as an alternative to penetrating
keratoplasty a report by the american academy of ophthalmology. Ophthalmology.
2011;118(1):209-18.,33 Lee WB, Jacobs DS, Musch DC, Kaufman SC, Reinhart WJ, Shtein RM.
Descemet's stripping endothelial keratoplasty: safety and outcomes: a report by
the American Academy of Ophthalmology. Ophthalmology. 2009;116(9):1818-30.
Review.,99 Keenan TD, Jones MN, Rushton S, Carley FM; National Health Service
Blood and Transplant Ocular Tissue Advisory Group and Contributing
Ophthalmologists (Ocular Tissue Advisory Group Audit Study 8).Trends in the
indications for corneal graft surgery in the United Kingdom: 1999 through 2009.
Arch Ophthalmol. 2012;130(5):621-8.,1010 Eye Bank Association of America. 2012 Banking statiscal report
[Internet]. Washington, DC: Eye Bank Association of America; 2013 [cited 2013
Feb 10].Available from:
http://www.restoresight.org/wp-content/uploads/2013/04/2012_Statistical_Report_FINAL-reduced-size-4-10.pdf
http://www.restoresight.org/wp-content/u...
),
as keratoconus and endothelial dysfunction. These two diseases remain among the
top three causes of transplants in world(99 Keenan TD, Jones MN, Rushton S, Carley FM; National Health Service
Blood and Transplant Ocular Tissue Advisory Group and Contributing
Ophthalmologists (Ocular Tissue Advisory Group Audit Study 8).Trends in the
indications for corneal graft surgery in the United Kingdom: 1999 through 2009.
Arch Ophthalmol. 2012;130(5):621-8.,1010 Eye Bank Association of America. 2012 Banking statiscal report
[Internet]. Washington, DC: Eye Bank Association of America; 2013 [cited 2013
Feb 10].Available from:
http://www.restoresight.org/wp-content/uploads/2013/04/2012_Statistical_Report_FINAL-reduced-size-4-10.pdf
http://www.restoresight.org/wp-content/u...
).
This review aims to make a comparative review between the updated models of Brazilian, United Kingdon and American Eye Banks. Like, check what the trend towards lamellar transplants in these three countries.
In Brazil Transplants
Brazil ranks second in the absolute number of transplants performed annually
worldwide. If we consider the relative number of transplants and GDP (gross
national product), Brazil ranks third, favored by investments made in this area
and the stimulus given to its increase(1111 Sistema Nacional de Transplantes. [citado 2012 Abr 21]. Disponível
em: http://www.cbo.com.br/novo/medico/pdf/02-cegueira.pdf
http://www.cbo.com.br/novo/medico/pdf/02...
). Table
1 shows the evolution of the types of transplants in Brazil between
2001 and 2011.
The importance of corneal transplantation (CT) for Brazil can be observed, both
by popular demand as the state investment, as represented 63.42% of all
transplants performed in Brazil in 2011. In 2009, the MS invested about R$ 900
million in transplants(1212 Flaeschen D. Transplantes. Doa-se vida: Brasil dispara em
transplantes de órgãos e cresce também em número de doadores. IPEA [periódico na
internet]. 2010. [citado 2012 Abr 21];63 [cerca de 5p.]. Disponível em:
http://www.ipea.gov.br/desafios/
index.php?option=com_content&view=article&id=1297:reportagens-materias&Itemid=39
http://www.ipea.gov.br/desafios/
...
). Despite the increase in the number of corneal
transplants in Brazil, can be seen in Table
2 the great difference in numbers of transplants in several Brazilian
States over the years, which reflects the inefficiency in generating a model of
Eye Banks efficient nationwide.
Can be observed that there are states that do not perform any CT in 2011, another did not perform CT between 2001-2009, and that there are more developed states having fewer transplants than other less developed. On the other hand, only the State of São Paulo was responsible for 37.39% of corneal transplants performed in Brazil in 2011.
Lamellar Transplants
Of these nearly 15,000 CT held in Brazil in 2011, do not know for sure how many were LT and how many were PK, because there isn't this kind of statistical control in Brazil.
In United Kingdon
Like in Brazil, if no wish has been expressed in life then specially trained
healthcare professionals should approach the family for their authorization to
proceed, based on their knowledge of the potential donor
(opt-in)(1313 Organ donation. Organ donation: teaching resource pack [internet].
Edinburgh: Scottish executive; 2003 [cited 2013 Feb 10]. Available from:
http://www.scotland.gov.uk/Publications/2003/11/18095/25886
http://www.scotland.gov.uk/Publications/...
).
Currently there are 14 European nations operating under a system of opt-out or
'presumed consent': Austria, Belgium, Czech Republic, Finland, France, Greece,
Hungary, Italy, Luxembourg, Poland, Portugal, Slovak Republic, Spain,
Sweden(1313 Organ donation. Organ donation: teaching resource pack [internet].
Edinburgh: Scottish executive; 2003 [cited 2013 Feb 10]. Available from:
http://www.scotland.gov.uk/Publications/2003/11/18095/25886
http://www.scotland.gov.uk/Publications/...
). In
UK, 16.124.871 people (The total at 31 March 2009) registered on the NHS Organ
Donor Register(1313 Organ donation. Organ donation: teaching resource pack [internet].
Edinburgh: Scottish executive; 2003 [cited 2013 Feb 10]. Available from:
http://www.scotland.gov.uk/Publications/2003/11/18095/25886
http://www.scotland.gov.uk/Publications/...
)
(a web based database).
Transplants
Figure 1 shows the evolution of the number of corneas donated and the number of
corneas grafted in the UK between 2002 and 2012(1414 UK Activity Report 2001-2012 [Internet]. [cited 2014 Mar 16].
Available from:
http://www.organdonation.nhs.uk/statistics/transplant_activity_report/archive_activity_reports/
http://www.organdonation.nhs.uk/statisti...
).
Evolution of the number of corneas donated and the number of corneas grafted in the UK between 2002 and 2012(1414 UK Activity Report 2001-2012 [Internet]. [cited 2014 Mar 16]. Available from: http://www.organdonation.nhs.uk/statistics/transplant_activity_report/archive_activity_reports/
http://www.organdonation.nhs.uk/statisti... )
Figure 2 shows the evolution, in a decade, of the numbers of LT for keratoconus, preserving the patient's healthy endothelium and changing only the corneal stroma(99 Keenan TD, Jones MN, Rushton S, Carley FM; National Health Service Blood and Transplant Ocular Tissue Advisory Group and Contributing Ophthalmologists (Ocular Tissue Advisory Group Audit Study 8).Trends in the indications for corneal graft surgery in the United Kingdom: 1999 through 2009. Arch Ophthalmol. 2012;130(5):621-8.).
Evolution, in a decade, of the numbers of LT for keratoconus. PK: Penetrant keratoplasty, DALK: Deep anterior lamellar keratoplasty(99 Keenan TD, Jones MN, Rushton S, Carley FM; National Health Service Blood and Transplant Ocular Tissue Advisory Group and Contributing Ophthalmologists (Ocular Tissue Advisory Group Audit Study 8).Trends in the indications for corneal graft surgery in the United Kingdom: 1999 through 2009. Arch Ophthalmol. 2012;130(5):621-8.)
Figure 3 shows the evolution, in a decade, of the numbers of LT for endothelial failure, preserving the patient's healthy stroma and changing only the corneal endothelium(99 Keenan TD, Jones MN, Rushton S, Carley FM; National Health Service Blood and Transplant Ocular Tissue Advisory Group and Contributing Ophthalmologists (Ocular Tissue Advisory Group Audit Study 8).Trends in the indications for corneal graft surgery in the United Kingdom: 1999 through 2009. Arch Ophthalmol. 2012;130(5):621-8.).
Evolution, in a decade, of the numbers of LT for endothelial failure, preserving the patient’s healthy stroma and changing only the corneal endothelium(99 Keenan TD, Jones MN, Rushton S, Carley FM; National Health Service Blood and Transplant Ocular Tissue Advisory Group and Contributing Ophthalmologists (Ocular Tissue Advisory Group Audit Study 8).Trends in the indications for corneal graft surgery in the United Kingdom: 1999 through 2009. Arch Ophthalmol. 2012;130(5):621-8.); PK: Penetrant keratoplasty; EK: Endothelium keratoplasty
In the UK it is possible to request and receive from Eye Bank a corneal donor lamella with specific thickness and diameter to the realization of LT. As in Brazil, the patient dosen't pay to the donnor cornea.
In United States
Currently, there are 84 Eye Banks in the U.S. In 2013, the Eye Bank Association
of America (EBAA) published the statistical report for 2012(1010 Eye Bank Association of America. 2012 Banking statiscal report
[Internet]. Washington, DC: Eye Bank Association of America; 2013 [cited 2013
Feb 10].Available from:
http://www.restoresight.org/wp-content/uploads/2013/04/2012_Statistical_Report_FINAL-reduced-size-4-10.pdf
http://www.restoresight.org/wp-content/u...
). Since 2011, the EBAA began
a new monthly collection methodology for the Statistical Report using EBAA
CONNECT, a real-time, web-based statistical reporting and analytics engine
designed specifically for the EBAA by Transplant Connect©(1010 Eye Bank Association of America. 2012 Banking statiscal report
[Internet]. Washington, DC: Eye Bank Association of America; 2013 [cited 2013
Feb 10].Available from:
http://www.restoresight.org/wp-content/uploads/2013/04/2012_Statistical_Report_FINAL-reduced-size-4-10.pdf
http://www.restoresight.org/wp-content/u...
). In this study, the data
reported were from 80 Eye Banks. Prior to 2008, all keratoplasties were counted
as "penetrating keratoplasty". From 2008, pre-cut and uncut tissue
utilization was stratified into penetrating grafts (PK), endothelial
keratoplasty (EK), anterior lamellar keratoplasty (ALK), keratolimbal allografts
(KLA), and tectonic grafts (TK). Keratoprosthesis (K-Pro) as a specific
utilization was added in 2009. Before 2009, domestic and international data from
U.S eye banks were combined. In 2009 and 2010, stratified data was only
collected for tissue distributed and used within the U.S. For 2011 and beyond,
tissue provided by U.S. eye banks was stratified and separated into domestic and
international use. International use of tissue sent from U.S. eye banks was
generally not included in statistical analysis before 201(1010 Eye Bank Association of America. 2012 Banking statiscal report
[Internet]. Washington, DC: Eye Bank Association of America; 2013 [cited 2013
Feb 10].Available from:
http://www.restoresight.org/wp-content/uploads/2013/04/2012_Statistical_Report_FINAL-reduced-size-4-10.pdf
http://www.restoresight.org/wp-content/u...
). Beginning in 2012, eight
international banks began using the EBAA Connect data system(1010 Eye Bank Association of America. 2012 Banking statiscal report
[Internet]. Washington, DC: Eye Bank Association of America; 2013 [cited 2013
Feb 10].Available from:
http://www.restoresight.org/wp-content/uploads/2013/04/2012_Statistical_Report_FINAL-reduced-size-4-10.pdf
http://www.restoresight.org/wp-content/u...
).
Transplants
In the U.S., tissue supplied by U.S. Eye Banks for all keratoplasty procedures
types in 2012 was 68,681. Of these tissues, 46.684 were used to transplants in
US and 19,546 corneas were exported internationally(1010 Eye Bank Association of America. 2012 Banking statiscal report
[Internet]. Washington, DC: Eye Bank Association of America; 2013 [cited 2013
Feb 10].Available from:
http://www.restoresight.org/wp-content/uploads/2013/04/2012_Statistical_Report_FINAL-reduced-size-4-10.pdf
http://www.restoresight.org/wp-content/u...
). The Figure 4 shows the
annual number of corneal transplants supplied by U.S. Eye Banks (US and
exported)(1010 Eye Bank Association of America. 2012 Banking statiscal report
[Internet]. Washington, DC: Eye Bank Association of America; 2013 [cited 2013
Feb 10].Available from:
http://www.restoresight.org/wp-content/uploads/2013/04/2012_Statistical_Report_FINAL-reduced-size-4-10.pdf
http://www.restoresight.org/wp-content/u...
).
Shows the annual number of corneal transplants supplied by U.S. Eye Banks (US and exported)(1010 Eye Bank Association of America. 2012 Banking statiscal report [Internet]. Washington, DC: Eye Bank Association of America; 2013 [cited 2013 Feb 10].Available from: http://www.restoresight.org/wp-content/uploads/2013/04/2012_Statistical_Report_FINAL-reduced-size-4-10.pdf
http://www.restoresight.org/wp-content/u... )
Figure 5 shows annually, the number of corneas available and how these have been
used for transplants in the USA between 1991-2012(1010 Eye Bank Association of America. 2012 Banking statiscal report
[Internet]. Washington, DC: Eye Bank Association of America; 2013 [cited 2013
Feb 10].Available from:
http://www.restoresight.org/wp-content/uploads/2013/04/2012_Statistical_Report_FINAL-reduced-size-4-10.pdf
http://www.restoresight.org/wp-content/u...
).
Number of corneas available and how these have been used for transplants in the USA between 1991-2012; in 2011 and progressing, long-term preserved corneal tissue is included in the total(10). (3)Until 2010, corneal grafts total did not include long-term preserved corneal tissue
Lamellar Transplants
Figure 6 shows the annual number of surgeries by type of cornea transplant
between 2005-2012(1010 Eye Bank Association of America. 2012 Banking statiscal report
[Internet]. Washington, DC: Eye Bank Association of America; 2013 [cited 2013
Feb 10].Available from:
http://www.restoresight.org/wp-content/uploads/2013/04/2012_Statistical_Report_FINAL-reduced-size-4-10.pdf
http://www.restoresight.org/wp-content/u...
).
It can be seen that since 2011 the number of LT (anterior and posterior) is greater than the number of PK, and that in 2012 the number of posterior LT alone was greater than the number of PK.
In the United States all Eye Banks provide donor corneal lamellae. The current
cost of a corneal donor (lamella or not) varies on average between US$ 1,949.00
to US$ 2,449.00(1515 Eye Bank Association of America. Cost-benefit analysis of corneal
transplant [internet]. Washington, DC: Eye Bank Association of America; 2013
[cited 2013 Feb 10]. Available from:
http://www.restoresight.org/wp-content/uploads/2013/09/Lewin-Study-2013.pdf
http://www.restoresight.org/wp-content/u...
).
Comments and suggestions
Although the penetrating keratoplasty indications were similar in the
world(99 Keenan TD, Jones MN, Rushton S, Carley FM; National Health Service
Blood and Transplant Ocular Tissue Advisory Group and Contributing
Ophthalmologists (Ocular Tissue Advisory Group Audit Study 8).Trends in the
indications for corneal graft surgery in the United Kingdom: 1999 through 2009.
Arch Ophthalmol. 2012;130(5):621-8.,1010 Eye Bank Association of America. 2012 Banking statiscal report
[Internet]. Washington, DC: Eye Bank Association of America; 2013 [cited 2013
Feb 10].Available from:
http://www.restoresight.org/wp-content/uploads/2013/04/2012_Statistical_Report_FINAL-reduced-size-4-10.pdf
http://www.restoresight.org/wp-content/u...
,1616 Victor G, Barth B, Signorelli Junior A. [Evaluate penetrating
keratoplasty indications]. Rev Bras Oftalmol. 2002;61(3):174-8.
Portuguese.
17 Ghosheh FR, Cremona F, Ayres BD, Hammersmith KM, Cohen EJ, Raber IM,
et al. Indications for penetrating keratoplasty and associated procedures,
2001-2005. Eye Contact Lens. 2008;34(4):211-4.
18 Zhang C, Xu J. Indications for penetrating keratoplasty in East
China, 1994-2003. Graefes Arch Clin Exp Ophthalmol.
2005;243(10):1005-9.
21 Hilgert CV, Sato ÉH. [Management performance of eye banks and its
impact on those organizations results]. Rev Bras Oftalmol. 2012;71(1):28-35.
Portuguese.-2022 Kara-Junior N, Mourad PC, Espíndola RA, AbilRuss HH. [Expectation
and knowledge among patients with keratoplasty indication]. Rev Bras Oftalmol.
2011;70(4):230-4.), management of eye banks model have improved in
Brazil(21) and the Brazilian corneal surgeons perform the most
updated techniques of CT, it can be seen that there is an inefficiency of the
Brazilian system at the national level by the huge discrepancy in the number of
transplants in several Brazilian states. In 2010, only São Paulo made 1.7 times
more CT than all UK did in 2012. In 2011, Brazil made 4.2 times more CT than all
UK did in 2012. In the other hand, in 2011, the EUA performed 3.11 times more CT
than Brazil in the same year. In this same period, the US exported more corneas
than the number of CT across Brazil. Thus it is important to consider whether
the Brazilians Eye Bank are following trends and best practices of other major
Eye Banks in the First World. The three countries use the opt-in system for
cornea donation.
Clearly, it is observed that in the United States (since 2011) and the UK (since 2009) are performed more posterior LT (endothelial) than PK. There is also a significant number of anterior LT in these countries. In this issue specifically, in Brazil the vast majority of Eye Banks as corneal surgeons do not have equipment (microkeratome, artificial anterior chambers, femtosecond lasers) for manufacturing their own donor corneal lamellar (anterior or posterior) from the donor corneal-scleral button. Thus, the number of LT performed in Brazil is a tiny fraction of the total CT. So, despite being a global trend, the LT is not encouraged by the Brazilian Eye Bank System, where there is practically no supply of donor corneal lamellae by Eye Banks, as in England or the United States have.
Suggestions
1. Investment in national awareness campaigns, guidance and fundraising (donations, web-donations with CBO help);
2. Specific guidance program to improve patient's knowledge about the main causes of CT and its treatments(22);
3. Developing a specific guidance program on protocols related to the importance, capture and donation of organs and tissues for TC, intended for all physicians and key stakeholders such as: CNCDOs, Intra-Hospital commissions, State and Municipal Health;
4. Investment for the 24 hours system of communication, transportation and collection nationwide;
5. Allow Eye Banks operate outside hospitals;
6. Partnership between the MS and the Brazilian Council of Ophthalmology (CBO) to develop and implement, in all national Eye Banks, software for on-line management, supervision and control of donated tissues and all types of cornea transplants;
7. Investment in equipment, material and human resources in Eye Banks for the possibility of making donor corneal lamellae;
8. Possibility to enrollment lamellar transplant (anterior and posterior) on Eye Banks;
9. Creating a web based database for the population could enroll as organ donors and tissues, as well as be able to make financial donations.
Referências
-
1von Hippel A. Eine neue Methode der Hornhauttransplantation. Albrecht Von Graefes Arch Ophthalmol. 1888;34(1):108-30.
-
2Reinhart WJ, Musch DC, Jacobs DS, Lee WB, Kaufman SC, Shtein RM. Deep anterior lamellar keratoplasty as an alternative to penetrating keratoplasty a report by the american academy of ophthalmology. Ophthalmology. 2011;118(1):209-18.
-
3Lee WB, Jacobs DS, Musch DC, Kaufman SC, Reinhart WJ, Shtein RM. Descemet's stripping endothelial keratoplasty: safety and outcomes: a report by the American Academy of Ophthalmology. Ophthalmology. 2009;116(9):1818-30. Review.
-
4Baptista GV. Método de avaliação da qualidade de corte na confecção de lamela corneana pediculada por microcerátomo em laser in situ ceratomileusis [tese]. Ribeirão Preto: Universidade de São Paulo; 2005.
-
5Behrens A, Dolorico AM, Kara DT, Novick LH, McDonnell PJ, Chao LC, et al. Precision and accuracy of an artificial anterior chamber system in obtaining corneal lenticules for lamellar keratoplasty. J Cataract Refract Surg. 2001;27(10):1679-87.
-
6Springs CL, Joseph MA, Odom JV, Wiley LA. Predictability of donor lamellar graft diameter and thickness in an artificial anterior cham-ber system. Cornea. 2002;21(7):696-9.
-
7Victor G, Faria e Sousa SJ,Alves MR, Nosé W. [MALKS: specifications and development]. Arq Bras Oftalmol. 2006;69(2):151-5.
-
8Victor G, Sousa SJ, Alves MR, Nosé W. Evaluation of a new system for obtaining donor lamellar grafts. Cornea. 2007;26(2):151-3.
-
9Keenan TD, Jones MN, Rushton S, Carley FM; National Health Service Blood and Transplant Ocular Tissue Advisory Group and Contributing Ophthalmologists (Ocular Tissue Advisory Group Audit Study 8).Trends in the indications for corneal graft surgery in the United Kingdom: 1999 through 2009. Arch Ophthalmol. 2012;130(5):621-8.
-
10Eye Bank Association of America. 2012 Banking statiscal report [Internet]. Washington, DC: Eye Bank Association of America; 2013 [cited 2013 Feb 10].Available from: http://www.restoresight.org/wp-content/uploads/2013/04/2012_Statistical_Report_FINAL-reduced-size-4-10.pdf
» http://www.restoresight.org/wp-content/uploads/2013/04/2012_Statistical_Report_FINAL-reduced-size-4-10.pdf -
11Sistema Nacional de Transplantes. [citado 2012 Abr 21]. Disponível em: http://www.cbo.com.br/novo/medico/pdf/02-cegueira.pdf
» http://www.cbo.com.br/novo/medico/pdf/02-cegueira.pdf -
12Flaeschen D. Transplantes. Doa-se vida: Brasil dispara em transplantes de órgãos e cresce também em número de doadores. IPEA [periódico na internet]. 2010. [citado 2012 Abr 21];63 [cerca de 5p.]. Disponível em: http://www.ipea.gov.br/desafios/ index.php?option=com_content&view=article&id=1297:reportagens-materias&Itemid=39
» http://www.ipea.gov.br/desafios/ index.php?option=com_content&view=article&id=1297:reportagens-materias&Itemid=39 -
13Organ donation. Organ donation: teaching resource pack [internet]. Edinburgh: Scottish executive; 2003 [cited 2013 Feb 10]. Available from: http://www.scotland.gov.uk/Publications/2003/11/18095/25886
» http://www.scotland.gov.uk/Publications/2003/11/18095/25886 -
14UK Activity Report 2001-2012 [Internet]. [cited 2014 Mar 16]. Available from: http://www.organdonation.nhs.uk/statistics/transplant_activity_report/archive_activity_reports/
» http://www.organdonation.nhs.uk/statistics/transplant_activity_report/archive_activity_reports/ -
15Eye Bank Association of America. Cost-benefit analysis of corneal transplant [internet]. Washington, DC: Eye Bank Association of America; 2013 [cited 2013 Feb 10]. Available from: http://www.restoresight.org/wp-content/uploads/2013/09/Lewin-Study-2013.pdf
» http://www.restoresight.org/wp-content/uploads/2013/09/Lewin-Study-2013.pdf -
16Victor G, Barth B, Signorelli Junior A. [Evaluate penetrating keratoplasty indications]. Rev Bras Oftalmol. 2002;61(3):174-8. Portuguese.
-
17Ghosheh FR, Cremona F, Ayres BD, Hammersmith KM, Cohen EJ, Raber IM, et al. Indications for penetrating keratoplasty and associated procedures, 2001-2005. Eye Contact Lens. 2008;34(4):211-4.
-
18Zhang C, Xu J. Indications for penetrating keratoplasty in East China, 1994-2003. Graefes Arch Clin Exp Ophthalmol. 2005;243(10):1005-9.
-
21Hilgert CV, Sato ÉH. [Management performance of eye banks and its impact on those organizations results]. Rev Bras Oftalmol. 2012;71(1):28-35. Portuguese.
-
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Publication Dates
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Publication in this collection
Nov-Dec 2014
History
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Received
01 Feb 2014 -
Accepted
17 Mar 2014