Descemet’s membrane detachment in a corneal graft after removal of a Baerveldt Shunt Intraluminal Stent

Objective@#We reported a case of Descemet's membrane detachment (DMD) following ripcord removal of a Baerveldt shunt in a post-corneal transplant eye, and the interventions done.@*Method@#This is a case report@*Results@#A 65-year-old male with multiple surgeries (phacoemulsification, two corneal transplants, and Baerveldt shunt implantation) in the right eye developed increased intraocular pressures, prompting removal of the intraluminal stent (ripcord) of the shunt. This was complicated by hypotony and DMD. Ripcord reinsertion and viscoelastic injection were performed to reattach the Descemet's membrane (DM) but failed. 0.1mL of 14% perfluoropropane (C3F8) gas was injected into the anterior chamber that successfully reattached the DM with return to pre-operative best-corrected visual acuity after 1 week. @*Conclusion@#Injection of an expansive gas (C3F8) was effective in repairing a corneal graft DMD in an eye with a Baerveldt shunt.

Experimental study on rabbit lamellar corneal transplantation with double-layer corneal stromal lens attactched by fibrin sealant / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To study the biocompatibility of double-layer corneal stromal lens attactched by fibrin sealant(FS)<i>in vivo</i>, and to explore the feasibility of using this material for corneal transplantation.<p>METHODS: Fifteen healthy and clean New Zealand white rabbits were selected for a self-control study. The right eye of the rabbit was used as the experimental eye and the left eye was used as the control eye. The experimental eyes used FS adhesived double-layer corneal stromal lens as the material for lamellar keratoplasty, and the control eyes did not undergo manual intervention. At 7,14, and 28d after surgery, a hand-held slit lamp was used to observe the cornea of the rabbits and then score the biocompatibility. The corneas of both eyes were taken for histopathological examination by HE staining to observe the corneal recovery at the same time.<p>RESULTS: Slit lamp observation results showed that by 28d after the operation, the corneal epithelium of the experimental eyes grew well, the degree of corneal transparency was basically restored, the degree of edema was reduced, the growth of neovascularization to the corneal edge was not aggravated, and no rejection reaction such as epithelial and endothelial rejection lines were seen; The control eyes had clear corneas and smooth corneal epithelium. The results of biocompatibility score showed that the degree of corneal implant edema gradually decreased, the transparency gradually recovered, the rejection reaction was less, and the biocompatibility of corneal implants was better in the experimental eyes after corneal transplantation. There were no differences in the degree of corneal transparency, edema and neovascularization growth between the experimental and control eyes at 28d after surgery(<i>P</i>>0.01). The results of histopathological examination showed that by 28d after corneal transplantation, there were 4-5 layers of corneal epithelial cells covering the surface of the implant in the experimental eyes, the corneal collagen was neatly and regularly arranged, no obvious inflammatory cell infiltration was seen in the implant, the boundary between the two lenses disappeared, the interlayer FS was completely absorbed by the organism, the implant was fused with the implant bed, and no obvious demarcation was seen.<p>CONCLUSION:Using FS pasted double-layer corneal stroma lens as a graft for lamellar keratoplasty has better recovery, less rejection and better biocompatibility, and can be used for lamellar keratoplasty.

Etiologia e Perfil Epidemiológico das Ceratites Fúngicas no Hospital São Geraldo/Hospital das Clínicas da Universidade Federal de Minas Gerais / Etiology and Epidemiological Profile of Fungal Keratitis at Hospital São Geraldo/Hospital das Clínicas of the Federal University of Minas Gerais

Objetivo: Investigar a etiologia e o perfil epidemiológico da ceratite fúngica (CF) em um centro de referência no estado de Minas Gerais. Design: Estudo retrospectivo longitudinal Métodos: Foram revisados os prontuários de pacientes com ceratite fúngica comprovada laboratorialmente no Hospital São Geraldo/HC-UFMG de janeiro de 2015 a dezembro de 2020. Resultados: Foram incluídos 114 pacientes. Destes, 81,6% eram do sexo masculino, com idade média de 47,3 anos e 79,2% oriundos de zonas rurais. Em 60% dos casos, a admissão no serviço foi entre os meses de maio a setembro. O principal fator predisponente encontrado foi o trauma ocular, registrado em 59,1% dos pacientes, sendo que, em 41,3% destes, o trauma se deu com material vegetal. Além disso, 40,1% tinham doenças sistêmicas, 15% dos pacientes tinham doenças oculares prévias, 13,2% tinham história de cirurgias oculares anteriores e 2,7 % eram usuários de lente de contato. Ao exame inicial, 56,4% dos pacientes apresentavam acuidade visual (AV) > 2,0 (LogMAR), 37,2% hipópio, 34,6% infiltrado estromal maior que 5 mm e 15% perfuração ocular. Os fungos filamentosos foram os mais prevalentes (103/114 casos; 90,3%), sendo que o Fusarium foi o gênero mais frequente entre os filamentosos (72/103; 70%), seguido de Aspergillus (20/103; 19,4%). Dos fungos leveduriformes, tivemos 11 casos de Candida sp. (9,6%), sendo sete casos de Candida albicans (63,7%), um de Candida parapsilosis (9,1%) e três casos sem identificação da espécie (27,3%). Dos 114 pacientes, 102 (89,5%) receberam tratamento com antifúngico tópico; em 96 (94,1%) olhos foi utilizada pimaricina e, em 50 olhos (49%), anfotericina B. Antifúngico sistêmico foi utilizado por 88/113 pacientes (77,9%). Transplante de córnea terapêutico foi necessário em 54/113 pacientes (47,8%). Houve recidiva no enxerto transplantado em 12 olhos (22,2%), em média 13 dias após o transplante. Complicações oculares da CF foram observadas em 56/111 pacientes (50,5%). O tempo de cicatrização foi em média de 40 dias (mediana: 36,5 dias). Logo após a cura, a AV ficou > 2,0 (LogMAR) em 58 pacientes (61,1%). À análise de regressão logística multivariada, os fatores de risco significativos (p<0,05) para ocorrência de perfuração e/ou necessidade de transplante de córnea terapêutico foram o tamanho do infiltrado corneano > 5 mm na maior extensão e AV inicial (LogMAR) > 2,0. Conclusões: Este é o estudo com o maior número de casos abordando o perfil etiológico e epidemiológico da ceratite fúngica no estado de Minas Gerais, Brasil. A CF foi predominante em homens adultos jovens oriundos de zonas rurais, nos meses de maio a setembro, coincidente com a época de maior atividade agrícola do estado. O principal fator de risco foi o trauma ocular. Fusarium sp. seguido de Aspergillus sp. foram os patógenos predominantes das CF na região estudada. Palavras chave: Ceratite fúngica. Infecção corneana. Epidemiologia. Etiologia. Transplante de córnea.

Objective: To investigate the etiology and epidemiological profile of fungal keratitis (FK) in a referral center in the state of Minas Gerais. Design: Longitudinal retrospective study Methods: We reviewed the medical records of patients with laboratory-proven fungal keratitis at Hospital São Geraldo/HC-UFMG from January 2015 to December 2020. Results: 114 patients were included. Of these, 81.6% were male, with a mean age of 47.3 years and 79.2% came from rural areas. In 60% of the cases, admission was between the months of May and September. The main predisposing factor was ocular trauma, recorded in 59.1% of the patients, and in 41.3% of these, trauma occurred with vegetable matter. In addition, 40.1% had systemic diseases, 15% had other eye diseases, 13.2% had a history of previous ocular surgeries, and 2.7% were contact lens wearers. At presentation, 56.4% of the patients had visual acuity (VA) > 2.0 (LogMAR), 37.2% had hypopyon, 34.6% displayed stromal infiltrate greater than 5 mm and 15% had ocular perforation. Filamentous fungi were the most prevalent (103/114 cases; 90.3%), with Fusarium being the most frequent genus among filamentous fungi (72/103; 70%), followed by Aspergillus (20/103; 19, 4%). Of the yeast-like fungi, we had 11 cases of Candida sp. (9.6%), being seven cases of Candida albicans (63.7%), one of Candida parapsilosis (9.1%) and three cases without identification of the species (27.3%). Of the 114 patients, 102 (89.5%) received topical antifungal treatment; pimaricin was used in 96 (94.1%) eyes and amphotericin B in 50 eyes (49%). Systemic antifungal was used by 88/113 patients (77.9%). Therapeutic corneal transplantation was required in 54/113 patients (47.8%). There was recurrence of fungal infection in the transplanted graft in 12 eyes (22.2%), at an average of 13 days after transplantation. Ocular complications of CF were observed in 56/111 patients (50.5%). Healing time averaged 40 days (median: 36.5 days). Immediately after healing, VA was > 2.0 (LogMAR) in 58 patients (61.1%). On multivariate logistic regression analysis, significant risk factors (p<0.05) for occurrence of perforation and/or need for therapeutic corneal transplantation were corneal infiltrate size > 5 mm at greatest extent and initial AV (LogMAR) > 2.0. Conclusions: This is largest investigation on the etiological and epidemiological profiles of fungal keratitis in the state of Minas Gerais, Brazil. FK was predominant in young adult men from rural areas, most frequently during period of high agricultural activity in the state, with the main risk factor being ocular trauma with vegetable matter. Fusarium sp. followed by Aspergillus sp. were the predominant pathogens implicated in FK in the region studied. Keywords: Fungal keratitis. Corneal infection. Epidemiology. Etiology. Corneal transplant.

Recent advances of exosomes in immune-mediated eye diseases / 国际眼科杂志(Guoji Yanke Zazhi)

@#Immune-mediated eye diseases(IMED)represent a kind of autoimmune eye diseases, such as thyroid-associated ophthalmopathy, autoimmune uveitis and Sjögren syndromes. Owning to its complicated pathophysiological mechanisms, the efficacies of current therapeutic strategies for IMED are unsatisfactory, which may ultimately result in severe visual impairment. Exosomes are lipid bilayer vesicles secreted by cells that play an important role in cell-to-cell communication and immune regulation. Recent studies have shown that exosomes secreted by cells under pathological conditions are closely associated with the development and progression of IMED, and the exosomes derived from certain cells(such as mesenchymal stem cells)are deemed as promising therapy for IMED. Hence, we review the recent advances of exosomes in IMED.

Epidemiological profile and study on waiting lists for corneal transplants in a tertiary hospital

INTRODUCTION: Epidemiological studies and about patients' waiting time on queues for corneal transplantation are important, as they allow us to know the assisted population and assist the medical team. OBJECTIVE: To evaluate the epidemiological and demographic profile of patients undergoing corneal transplantation from January 2014 to September 2018 at a teaching hospital in the city of Santo André, as well as their waiting time for the procedure. METHODS: Retrospective descriptive study, performed through analysis of medical records and data from the website of the Government of the State of São Paulo's transplant center. The study was conducted at the External and Corneal Diseases sector of the discipline of Ophthalmology from Centro Universitário FMABC. The following data were evaluated: gender, age, race, origin and waiting time for the patient to have a transplant. RESULTS: A total of 139 corneal transplant patients were recruited for the study, with a mean age of 47.4±23 years. According to gender, just over half of the transplanted were female (50.4%). Regarding to skin color, 45.3% of the patients were white, 44.6% were brown and 10.1% were black. As for their origin, most patients were from the city of Santo André. CONCLUSION: This study enabled the assessment and knowledge of the epidemiological profile and waiting time for corneal transplantation in our patients. This information is important, as it helps us to understand the profile of the assisted population and in the organization and planning of the medical team, contributing to better guidance and care for the patients.

Queratoplastia penetrante con y sin terapia antiviral en la queratopatía herpética / Penetrating keratoplasty with and without antiviral therapy in herpetic keratopathy

RESUMEN Objetivo: Identificar el resultado óptico o terapéutico de la queratoplastia penetrante en pacientes con queratopatía herpética. Métodos: Se realizó una investigación descriptiva, transversal, donde se expusieron los resultados del alcance de la queratoplastia penetrante por queratopatía herpética, operados en el Hospital Clínico Quirúrgico "Hermanos Ameijeiras", de La Habana. Resultados: La muestra fue de 33 queratoplastias penetrantes. Con fines ópticos sumaron 24 (72,7 por ciento) y tectónicas 9 (27,3 por ciento). En 5 de estas la agudeza visual fue menor o igual a 0,3. En el total de la muestra, 9 opacificaron, 11 sufrieron complicaciones posquirúrgicas, 8 recurrieron en queratoplastias penetrantes ópticas y 6 en queratoplastias penetrantes terapéuticas. Se rechazaron 7 queratoplastias penetrantes ópticas (33,3 por ciento) y 4 queratoplastias penetrantes terapéuticas (4 por ciento). Presentaron complicaciones 5 (25 por ciento) con queratoplastias penetrantes ópticas y 6 (55,6 por ciento) con queratoplastias penetrantes terapéuticas. En el posquirúrgico 22 (66,6 por ciento) tenían agudeza visual mayor o igual a 0,3 (p= 0,0000). Conclusiones: La inactividad de la enfermedad viral corneal beneficia el pronóstico del injerto por queratopatía herpética en las opacidades de las queratoplastias con fines ópticos. Queda demostrado que el uso de antivirales pre y posoperatorios disminuye la recidiva de la enfermedad herpética sobre el injerto y el rechazo, al lograr mejor agudeza visual y mayor viabilidad. La severidad inflamatoria posquirúrgica se asocia con la enfermedad viral activa o afección de origen inmune al realizar el trasplante, conexos a las complicaciones post queratoplastia(AU)

ABSTRACT Objective: Identify the optical or therapeutic outcome of penetrating keratoplasty in patients with herpetic keratopathy. Methods: A descriptive cross-sectional study was conducted in which a presentation was made of the results of the scope of penetrating keratoplasties for herpetic keratopathy performed at Hermanos Ameijeiras Clinical Surgical Hospital in Havana. Results: The sample was 33 penetrating keratoplasties: 24 optical (72.7 percent) and 9 tectonic (27.3 percent). Visual acuity was lower than or equal to 0.3 in 5 of them. Of the total sample, 9 opacified, 11 had postoperative complications, 8 recurred in optical penetrating keratoplasties, and 6 in therapeutic penetrating keratoplasties. Rejection occurred in 7 optical penetrating keratoplasties (33.3 percent) and 4 therapeutic penetrating keratoplasties (4%). Complications were observed in 5 (25 percent) optical penetrating keratoplasties and 6 (55.6 percent) therapeutic penetrating keratoplasties. In the postoperative period 22 (66.6 percent) had a visual acuity greater than or equal to 0.3 (p= 0.0000). Conclusions: Inactivity of corneal viral disease benefits the prognosis of grafting due to herpetic keratopathy in opacities of optical keratoplasties. Pre- and postoperative antivirals were found to reduce the recurrence of herpetic disease on the graft and rejection, achieving better visual acuity and greater viability. Postoperative inflammatory severity is associated to an active viral disease or an immune disorder at the time of the grafting resulting in post keratoplasty complications(AU)

Trasplante de córnea: aspectos bioéticos / Trasplante de córnea: aspectos bioéticos / Corneal transplant: bioethical aspects

Resumen: Este trabajo aborda los aspectos bioéticos del trasplante de córnea, desde la donación y los tipos de la misma, incluyendo el comercio de órganos y tejidos, así como la metodología del trasplante y el uso de tratamientos inmunosupresores, además del consentimiento informado y la participación del paciente en las decisiones. Se analizan las técnicas actuales, la efectividad y las circunstancias en las que se puede aplicar cada una de ellas así como los estudios emergentes basados en la terapia celular. Algunos de los estudios emplean células troncales derivadas de embriones humanos, y otras de tejidos adultos y células troncales pluripotentes inducidas (iPS). Se propone un análisis bioético de las consecuencias que pueden derivarse de las distintas opciones clínicas disponibles. Por último, se valora en qué medida el paciente participa como actor en su proceso de tratamiento, y la información de que dispone acerca de su enfermedad y del tratamiento que está recibiendo. El paciente debe ser parte activa en su proceso de curación y debe existir un proceso deliberativo en el que sea guiado por el personal facultativo en la elección de su tratamiento, teniendo en cuenta los principios éticos del paciente y del personal sanitario.

Resumo: Este trabalho aborda os aspectos bioéticos do transplante de córnea como a doação e os tipos da mesma (incluindo o comércio de órgãos e tecidos), a metodologia do transplante e uso de tratamentos imunossupressores, além do consentimento informado e a participação do paciente nas decisões. Analisam-se as técnicas atuais, a efetividade e as circunstancias nas quais se pode aplicar cada uma delas, assim como os estudos emergentes baseados na terapia celular. Se propõe uma análise bioética das consequências que podem ser derivadas das distintas opções clínicas disponíveis. Por último, se avalia em que medida o paciente participa como ator em seu processo de tratamento e a informação de que dispõe sobre sua doença e do tratamento que está recebendo. O paciente deve ser parte ativa em seu processo de cura e ser orientado pela equipe médica no processo deliberativo da eleição de seu tratamento, tendo em conta os princípios éticos do paciente e do pessoal de saúde.

Abstract: This paper addresses the bioethical aspects of corneal transplantation, from donation and types of donation, including the trade of organs and tissues, as well as the methodology of transplantation and use of immunosuppressive treatments, in addition to informed consent and patient participation. in decisions. The current techniques are analyzed, the effectiveness and the circumstances in which each of them can be applied as well as the emergent studies based on cell therapy. Some of the studies use stem cells derived from human embryos, and others from adult tissues and induced pluripotent stem cells (iPS). A bioethical analysis of the consequences may arise from the different clinical options available. A bioethical analysis of the consequences that can be derived from the different clinical options available is proposed. Finally, it is assessed to what extent the patient participates as an actor in their treatment process, and the information they have about their illness and the treatment they are receiving. The patient must be an active part in his healing process and there must be a deliberative process in which he is guided by the medical staff in the choice of his treatment, taking into account the ethical principles of the patient and the health personnel.

Indicaciones y técnicas de trasplante de córnea en una clínica oftalmológica privada en Colombia / Indications and techniques of corneal transplantation in a private ophthalmologic clinic in Colombia

Introducción: el trasplante de córnea es el injerto mas frecuente en el campo de la medicina; las técnicas para realizarlo han evolucionado permitiendo hacer procedimientos menos invasivos, con menor riesgo de rechazo del injerto y con una recuperación más rápida. La escasez de donantes para realizar trasplantes de córnea, genera una limitación terapéutica muy importante en el campo de la patología corneal. Objetivo: Reportar las Indicaciones y Técnicas empleadas en los Trasplantes de Córnea, en una institución privada con atención terciaria en Oftalmología en Bogotá, Colombia. Diseño del Estudio: Estudio transversal de fuentes secundarias. Método: Se hizo un estudio transversal, con las historias clínicas electrónicas de los pacientes operados con algún tipo de trasplante de córnea, en la Clínica Barraquer de América en el periodo comprendido desde Enero del 2010 a Diciembre del 2018 Resultados: Las cuatro primeras Indicaciones para Trasplantes de córnea fueron: 1) Ectasias Corneales 38.27% 2) Descompensación corneal 20.88% 3) Reposición de Injerto 17.72% 4) Leucomas Cicatriciales 16.22%. Las técnicas empleadas fueron Injerto Penetrante el 54.11% - Injertos Laminares (43.52%) con un 17.25% de Injertos Endoteliales. Conclusión: Existen diferencias en la frecuencia de las Indicaciones para trasplante de córnea según la región del país y también respecto a las publicaciones internacionales. El Queratocono fue la indicación mas frecuente. La Queratoplastia Penetrante la técnica más frecuente como procedimiento primario, pero también como técnica alternativa debido a la falta de oportunidad para realizar el trasplante.

Background: corneal transplant is the most frequent graft in the fi eld of medicine; the techniques to carry it out have evolved allowing to make less invasive procedures, with less risk of rejection of the graft and with a faster recovery. The shortage of donors to perform corneal transplants generates a very important therapeutic limitation in the field of corneal pathology.. Objective: To report the Indications and surgical techniques in Corneal Transplants in a tertiary referral center and private Ophthalmological clinic in Bogotá-ColombiaStudy Design: Cross sectional study using secondary data. Method: A cross sectional study was performed with the electronic clinical records of the patients that had a corneal graft of any kind during the period between January 2010 and December 2018 at the Barraquer Clinic in América. Results: The top four indications for corneal transplantation were: 1) Corneal Ectasias 38.27% - 2) Bullous Keratopathy 20.88% ­ 3) Re-Graft 17.72% and 4) Leucomas 16.22%. Penetrating Keratoplasty was the most common indication (54.11%) followed by Lamellar Techniques 43.52% of which Endothelial keratoplasty was performed in 17.25%. Conclusion: Corneal transplant indications and its frequency, are different between country regions in Colombia and towards international reviews. For us, Keratoconus was the most frequent indication. and Penetrating Keratoplasty, the most frequent technique as a primary procedure, but also as an alternative technique due to the lack of opportunity to perform the transplant.

Management of pediatric keratoconus – Evolving role of corneal collagen cross-linking: An update.

Pediatric keratoconus demonstrates several distinctive management issues in comparison with adult keratoconus with respect to under-diagnosis, poor compliance and modifications in treatment patterns. The major concerns comprise of the accelerated progression of the disease in the pediatric age group and management of co-morbidities such as vernal keratoconjuntivitis. Visual impairment in pediatric patients may affect social and educational development and overall negatively impact their quality of life. The treatment algorithm between adults and pediatric keratoconus has been similar; comprising mainly of visual rehabilitation with spectacles, contacts lenses (soft or rigid) and keratoplasty (lamellar or penetrating) depending on the stage of the disease. There is a paradigm shift in the management of keratoconus, a new treatment modality, corneal collagen crosslinking (CXL), has been utilized in adult keratoconic patients halting the progression of the disease. CXL has been utilized for over a 10 year period and based on the evidence of efficacy and safety in the adult population; this treatment has been recently utilized in management of pediatric keratoconus. This article will present an update about current management of pediatric keratoconus with special focus on CXL in this age group.

Microbiological profile of donor corneas stored for tectonic transplantation purposes in rabbits / Microbiologia de amostras de bancos de córneas destinadas a transplantes, em coelhos

This study aimed to evaluate the microbiota of donor rabbit corneas stored for tectonic transplantation purposes. Swabs from both corneas of 20 rabbits were carefully collected and submitted to microorganism isolation and identification. After this first swab collection, rabbits were euthanized for reasons other than this project and the eyes were enucleated. The corneas were collected and stored to compose the cornea tissue bank. Corneas were stored in a 0.3% tobramycin solution at -20ºC. After 30 days, the corneas were thawed at room temperature and removed from the antibiotic. New swabs were obtained from the corneas and submitted to microorganism isolation and identification. Gram positive organisms were predominant in the rabbit corneal flora before storage and the Staphylococcus sp. was the most common microorganism isolated from those samples. No growth was observed on the samples collected after storage. The methods used for collection and storage of the corneas were efficient to constitute a sterile donor corneal tissue bank.

Analisaram-se córneas armazenadas para transplantes tectônicos usando-se suabes coletados de 20 coelhos, visando ao isolamento e à identificação de microrganismos. Após a coleta das amostras, os coelhos foram submetidos à eutanásia, por razões alheias ao estudo, e enucleados. As córneas foram coletadas e armazenadas a fim de se constituir o banco de córneas. O armazenamento deu-se em solução de tobramicina 0,3% a -20ºC, por 30 dias. Após esse período, as córneas foram descongeladas à temperatura ambiente e removidas da solução de antibiótico. Novos suabes foram coletados e submetidos ao isolamento e à identificação dos microrganismos. A flora corneal mostrou-se predominantemente composta por bactérias Gram positivas, sendo o Staphylococcus sp. o mais identificado. Não se verificou crescimento de colônias bacterianas ou fúngicas nas amostras após o armazenamento. Considerando-se a maneira como a pesquisa foi concebida e as injunções do meio em que ela foi realizada, há como admitir, pela ausência de crescimento microbiano nas amostras armazenadas, que a técnica de armazenamento empregada é segura para a estocagem de córneas destinadas a transplantes.

Modelo de gestão em bancos de olhos e seu impacto no resultado destas organizações / Management performance of eye banks and its impact on those organizations results

OBJETIVO: Avaliar a eficácia do modelo de gestão adotado pelo Banco de Olhos de Sorocaba (BOS) e Banco de Olhos da Santa Casa de Campo Grande (BOSC), segundo os critérios do Prêmio Nacional de Gestão em Saúde (PNGS) e demonstrar as características comuns e discordantes entre os dois Bancos de Olhos e um paralelo entre a efetividade do modelo de gestão adotado e o resultado destas organizações na doação de córneas. MÉTODOS: Foi aplicado o questionário "Como estamos progredindo?", disponibilizado pela Fundação Malcolm Baldrige, composto por 40 questões fechadas agrupadas nos sete critérios do PNGS (Liderança, Planejamento Estratégico, Foco no Cliente e no Mercado, Foco em Recursos Humanos, Critério Gestão de Informações, Gestão de Processos, e Resultados) em toda a força de trabalho das duas instituições (21 funcionários do BOS e 8 do BOSC). Os resultados foram analisados utilizando o Teste Exato de Fischer e Teste não-paramétrico U de Mann-Whitney para comparação das médias entre as duas instituições. RESULTADOS: Foram entrevistados 21 funcionários do BOS e 8 funcionários do BOSC). O teste de Mann-Whitney mostrou uma maior concordância às proposições do questionário pelos respondentes do BOS em 6 dos 7 itens estudados (Liderança, Planejamento Estratégico, Foco no Cliente e no Mercado, Foco em Recursos Humanos, Gestão de Processos, e Resultados). Não houve diferença estatisticamente significativa no Critério Gestão de Informações. A maior diferença entre as duas instituições foi encontrada no critério Gestão de Processos (p<0.001). CONCLUSÃO: O modelo de gestão presente no BOS apresenta aspectos distintos e estatisticamente significantes comparados ao BOSC, em 6 dos 7 critérios estudados pelo questionário aplicado. O BOS é o que mais se aproxima de conceitos internacionalmente aceitos de excelência em gestão baseados nos critérios do PNGS do que o BOSC, sendo um dos motivos prováveis do resultado positivo no número de doações de córnea.

OBJECTIVE: To analyse the management of Sorocaba Eye Bank (BOS) and Santa Casa de Campo Grande Eye Bank (BOSC) with distinct results regarding number of donations using Prêmio Nacional Gestão em Saúde (PNGS) criteria for performance excellence. METHODS: All the personel of the two eye banks were submitted to an interview using the 'Are We Making Progress?' questionnaire from Malcolm Baldrige Quality Program. The questionnaire items were organized by the seven criteria categories, as the PNGS's (Leadership, Strategic Planning, Customer and Market Focus, Measurement, Analysis and Knowledge Management, Human Resource Focus, Process Management, Bussiness Results). The findings were studied upon Fischers' exact test and Non parametric U test (Mann-Whitney) to compare the medium scores between the two Institutions. RESULTS: Twenty-one employees from BOS and 08 from BOSC were submitted to the questionnaire. The Mann-Whitney test showed a higher level of agreement to the questionnaire proposals from BOS than the ones from BOSC in 6 out from the 7 items studied (Leadership, Strategic Planning, Costumer and Market Focus, Human Resource Focus, Process Management, Bussiness Results). There wasn't any statisticaly significant difference related to the criteria Measurement, Analysis and Knowledge Management. The highest difference on the concordance level between the two organizations was related to Process Management (p<0.001). CONCLUSION: The BOS management performance has distinct and statistically significant aspects compared to BOSC, shown on 6 out of 7 criteria studied by the questionnaire used. These data showed that the BOS performance management is closer to internationally accepted concepts of performance excellence, based on both PNGS Criteria and Malcolm Baldrige Quality Program, than BOSC.

What does the medical student know about eye donation/corneal transplant? The University of Nigeria scenario / ¿Qué saben los estudiantes de medicina acerca de la donación de ojos/transplante de córnea? Panorama de la Universidad de Nigeria

OBJECTIVE: The study was designed to determine the knowledge of eye donation and corneal transplant among final year medical students of The University of Nigeria, Enugu Campus (UNEC). METHODS: Self-administered structured questionnaires were distributed to the members of the final year (graduating) class of the Medical College of UNEC in June 2007. Responses were obtained to questions bordering on eye donation and corneal transplant. RESULTS: One hundred and thirty-one students out of 183 eligible students participated in the study (response rate = 71.6%). One hundred and four students (79.4%) were aware of eye donation/corneal transplant. However, 95 students (72.5%) were not aware that the eyes can only be removed from a dead donor. Eight-yfour students (64.1%) were not aware that eyes with cataract could be donated. Eighty-seven (66.4%) students were not willing to pledge their eyes for donation. CONCLUSION: Medical students lack adequate knowledge about some aspects of eye donation and corneal transplantation. This may be a predictor of the level of awareness among the general public. Concerted innovative education and information dissemination strategies are required at this stage of national development to address the misconceptions surrounding eye donation and corneal transplant. There is a need to target medical students as future motivators, counsellors and eye donors. This should help advance the eye donation rates in Nigeria whenever the plans for the establishment of an eye-bank are finalized.

OBJETIVO: El estudio fue diseñado para determinar el conocimiento sobre la donación de ojos y el trasplante de la córnea entre estudiantes del último año de medicina en el Campus Enugu de la Universidad de Nigeria (UNEC). MÉTODOS: Se distribuyeron encuestas estructuradas auto-administradas entre los miembros de la clase del último año (graduandos) de la Facultad de Medicina de UNEC en junio de 2007. Se obtuvieron respuestas a preguntas en torno a la donación de ojos y el trasplante de córnea. RESULTADOS: Ciento treinta y un estudiantes de un grupo de 183 estudiantes elegibles, participaron en el estudio (tasa de respuesta = 71.6%). Ciento cuatro estudiantes (79.4%) conocían de la donación de ojos/trasplante de córnea. Sin embargo, 95 estudiantes (72.5%) no sabían que los ojos sólo pueden ser extraídos de un donante muerto. Ochenta y cuatro estudiantes (64.1%) no tenían conciencia de que se podían donar ojos con catarata. Ochenta y siete (66.4%) estudiantes no estaban dispuestos a ofrecer sus ojos para una donación. CONCLUSIÓN: Los estudiantes de medicina carecían de conocimientos adecuados sobre algunos aspectos de la donación de ojos y el trasplante de la córnea. Éste puede ser un predictor del nivel de conocimiento en el público general. Se necesita concertar una educación innovadora y estrategias de difusión de la información en esta fase de desarrollo nacional, a fin de abordar las concepciones erróneas en torno a la donación de ojos y el trasplante de córnea. Hay que hacer un trabajo de captación de los estudiantes de medicina como futuros motivadores, orientadores, y donantes de ojos. Esto debe contribuir a elevar las tasas de donación de ojos en Nigeria, en cuanto se concreten los planes para la creación de un banco de ojos.