Complicações em transplantes endoteliais realizados por estagiários de córnea

OBJETIVO: Reportar complicacoes precoces numa serie de transplantes endoteliais realizados por estagiarios de cornea. METODOS: Revisao retrospectiva dos transplantes endoteliais realizados por estagiarios de cornea do segundo ano. Descritas as complicacoes precoces e respectivo tratamento. RESULTADOS: Foram realizados 34 transplantes endoteliais pelos estagiarios de cornea entre julho de 2007 e agosto de 2008. Destes, 29 foram realizados pela tecnica de "Descemet stripping endothelial keratoplasty" e 5 "Descemet stripping automated endothelial keratoplasty". Foram realizadas 15 cirurgias combinadas, 14 associadas a facoemulsificacao com implante de lente intraocular e 1 associada a facectomia com implante de lente intraocular. A principal indicacao foi por distrofia de Fuchs com 18 casos, 11 foram indicados por ceratopatia bolhosa apos cirurgia de catarata, 4 por falencia primaria apos transplante endotelial e 1 por distrofia endotelial congenita hereditaria. A complicacao mais encontrada foi descolamentos do botao doado em 8 olhos (23,5%). Falencia primaria foi encontrado em 7 olhos (20,6%). Glaucoma agudo por bloqueio pupilar foi encontrado em 1 paciente (2,9%). CONCLUSOES: O alto numero de complicacoes encontradas nestas cirurgias, que foram as primeiras de um grupo de 6 estagiarios de cornea, mostra a longa curva de aprendizado para este procedimento cirurgico. A orientacao das primeiras cirurgias por cirurgioes mais experientes pode diminuir a curva de aprendizado e a taxa de complicacoes.

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