Prevalence and causes of vision loss in Latin America and the Caribbean in 2015: magnitude, temporal trends and projections

Objective To estimate the prevalence and causes of blindness and vision impairment for distance and near in Latin America and the Caribbean (LAC) in 2015 and to forecast trends to 2020. Methods A meta-analysis from a global systematic review of 283 cross-sectional, population-representative studies from published and unpublished sources from 1980 to 2014 in the Global Vision Database included 17 published and 6 unpublished studies from LAC. Results In 2015, across LAC, age-standardised prevalence was 0.38% in all ages and 1.56% in those over age 50 for blindness; 2.06% in all ages and 7.86% in those over age 50 for moderate and severe vision impairment (MSVI); 1.89% in all ages and 6.93% in those over age 50 for mild vision impairment and 39.59% in all ages and 45.27% in those over 50 for near vision impairment (NVI). In 2015, 117.86 million persons were vision impaired; of those 2.34 million blind, 12.46 million with MSVI, 11.34 million mildly impaired and 91.72 million had NVI. Cataract is the most common cause of blindness. Undercorrected refractive-error is the most common cause of vision impairment. Conclusions These prevalence estimates indicate that one in five persons across LAC had some degree of vision loss in 2015. We predict that from 2015 to 2020, the absolute numbers of persons with vision loss will increase by 12% to 132.33 million, while the all-age age-standardised prevalence will decrease for blindness by 15% and for other distance vision impairment by 8%. All countries need epidemiologic research to establish accurate national estimates and trends. Universal eye health services must be included in universal health coverage reforms to address disparities, fragmentation and segmentation of healthcar

Corneal Transplantation in Children

The main purpose of the study was to describe the surgical success rate and visual results of penetrating keratoplasty in children. This retrospective study included children that underwent corneal transplantation at the Department of Ophthalmology, General Hospital »Sveti Duh«, in the period 1994–1999. Patients’ age ranged from 6 to 16 years. Twenty-five corneal transplants were performed in 24 eyes. Corneal pathologies were corneal leucoma, congenital dystrophy, corneal combustion, corneal scar after perforating injury, keratoconus, corneal melting, hematocornea and rekeratoplasty. The follow-up period was at least 6 months. The rate of graft survival was 1 year in 75% of eyes with congenital dystrophy and keratoconus. Hematocornea and rekeratoplasty ended with graft failure. Postoperative visual acuity improvement was recorded in 14 out of 25 eyes. Penetrating keratoplasty in children showed very good surgical success. The final visual outcome was affected by irreversible amblyopia

Pterygium Treatment with Limbal-Conjunctival Autograft Transplantation

The objective of this pilot study was to examine the usefulness of limbal autograft transplantation (LCAT) in the treatment of recurrent pterygium. Eleven eyes with advanced recurrent pterygium underwent LCAT. All eyes were previously treated at least two times either by simple excision (10) or conjunctival rotation autograft (1). In two eyes (18.18%) symblepharon was present at the time of surgery, therefore LCAT was combined with amniotic membrane transplantation. Limbal-conjunctival autograft was taken from supero-lateral part of the same eye and transferred to the area where pterygium was excised. No intraoperative complications occurred. In ten eyes (90.9%) no pterygium recurrence was recorded during the follow-up time, and one (9.1%) recurrence was recorded after 5 months. In two eyes with combined symblepharon formation remission of both pterygium and symblepharon growth was obtained. LCAT proved to be a promising and safe procedure in recurrent pterygium treatment

Multilayer vs. Monolayer Amniotic Membrane Transplantation for Deep Corneal Ulcer Treatment

The purpose of the study was to evaluate the efficacy of multilayer amniotic transplantation (AMT) for reconstruction of corneal stroma and epithelium. Corneal ulcer (28) was a consequence of a previous infectious or neurotrophic keratitis. In the first group (17) ulcer was covered with monolayer AM, while in the other group (11) there were two or more layers of AM situated in the ulcer and the whole cornea was covered with AM sheet. Monolayer AMT was successful in 64% while the multilayer AMT success rate was 72%. AM gradually dissolved within 3–6 postoperative weeks. AM transplantation facilitates rapid healing of corneal epithelium, reduces inflammation and stimulates epithelial cell regrowth. In eyes with deep corneal ulcer multilayer technique proved to be better then monolayer procedure

The Role of HLA-DRB1 Matching in Corneal Grafting

The aim of the study was to evaluate the role of HLA-DRB1 (Human Leukocyte Antigens) matching in corneal transplantation. Fifty-two patients were observed. Low-risk group consisted of 28 patients and high-risk group consisted of 24 patients. All the patients and donors were tissue typed with Polymerase Chain Reaction (PCR) on the HLADRB1 gen. The primary corneal disease preceding keratoplasty was keratopathia (15), leucoma (10), keratoconus (7), Re-KPP (6), impending perforation (4), combustio corneae (3), degenerative disorders (2), keratoglobus (1), keratouveitis (1), corneal maculae (1), and corneal melting syndrome (1). The graft rejection frequency was higher in the group of high-risk patients (29%) than in the group of low risk patients (7.1%). The rejection rate of compatible grafts was 37% for high risk and 2% for low risk group, while the rejection rate of incompatible was 44% in high risk and 5% in low risk group.We can conclude that HLA-DRB1 matching does not improve corneal graft survival