Sobrevida libre de rechazo o falla en pacientes sometidos a queratoplastia penetrante

datacite.rightshttp://purl.org/coar/access_right/c_16ec
dc.contributor.advisorPinto Osorio, Natina Ester
dc.contributor.advisorGonzález Torres, Henry J.
dc.contributor.authorCarpio Cordero, José Enrique
dc.contributor.authorSánchez Barahona, Juan David
dc.date.accessioned2025-07-04T20:12:34Z
dc.date.available2025-07-04T20:12:34Z
dc.date.issued2025
dc.description.abstractLa queratoplastia penetrante (QP) es una técnica quirúrgica ampliamente empleada para tratar enfermedades corneales que afectan la transparencia y funcionalidad visual. A pesar de los avances, el rechazo inmunológico y la falla del injerto siguen siendo desafíos relevantes para su sobrevida a largo plazo. Objetivo: Evaluar la sobrevida libre de rechazo o falla del injerto en pacientes sometidos a queratoplastia penetrante en una institución de referencia en Barranquilla entre 2018 y 2023. Métodos: Se realizó un estudio retrospectivo y analítico. Se incluyeron 299 pacientes mayores de 18 años con seguimiento postoperatorio ≥6 meses. Se recolectaron variables clínicas, quirúrgicas y del donante. Se aplicaron análisis descriptivos, pruebas de asociación (Chi-cuadrado, Wilcoxon) y curvas de KaplanMeier para estimar la sobrevida según sexo, medio de preservación y tiempo de isquemia. Se utilizó R (v4.3.3) para el análisis. Resultados: La sobrevida libre de rechazo o falla a los 12 meses fue del 91% (IC 95%: 87.6–94.5%). No se encontraron diferencias significativas por sexo ni por tiempo de isquemia. La tasa de rechazo fue mayor en injertos preservados con Optisol (22%) comparado con Eusol (7.3%, p<0.001), aunque la sobrevida general fue similar. El queratocono fue más frecuente en hombres jóvenes, mientras que leucomas y rechazos previos predominaron en mujeres mayores. Conclusión: La QP muestra una alta efectividad a corto plazo. El medio de preservación y la patología de base podrían influir en el riesgo de rechazo, lo que resalta la necesidad de estrategias individualizadas.spa
dc.description.abstractPenetrating keratoplasty (PK) is a widely used surgical technique for treating corneal diseases that impair transparency and visual function. Despite technical advances, graft rejection and failure remain significant challenges for long-term survival. Objective: To evaluate rejection-free or graft failure-free survival in patients undergoing penetrating keratoplasty at a referral institution in Barranquilla between 2018 and 2023. Methods: A retrospective, analytical study was conducted. A total of 299 patients aged >18 years with ≥6 months of postoperative follow-up were included. Clinical, surgical, and donor variables were collected. Descriptive statistics, chi-square and Wilcoxon tests were used, and Kaplan-Meier survival curves estimated graft survival by sex, preservation medium, and ischemia time. R software (v4.3.3) was used for analysis. Results: Graft survival free of rejection/failure at 12 months was 91% (95% CI: 87.6– 94.5%). No significant differences were observed by sex or ischemia time. Rejection was more frequent with grafts preserved in Optisol (22%) compared to Eusol (7.3%, p<0.001), although overall survival was similar. Keratoconus was more prevalent in younger males, whereas leucomas and prior rejections were more common in older females. Conclusion: PK demonstrates high short-term effectiveness. Preservation medium and underlying pathology may influence rejection risk, highlighting the importance of individualized strategies.eng
dc.format.mimetypepdf
dc.identifier.urihttps://hdl.handle.net/20.500.12442/16799
dc.language.isospa
dc.publisherEdiciones Universidad Simón Bolívarspa
dc.publisherFacultad de Ciencias de la Saludspa
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internationaleng
dc.rights.accessrightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectQueratoplastia penetrantespa
dc.subjectRechazo del injertospa
dc.subjectMedio de preservaciónspa
dc.subjectSobrevidaspa
dc.subjectCórneaspa
dc.subject.keywordsPenetrating keratoplastyeng
dc.subject.keywordsGraft rejectioneng
dc.subject.keywordsPreservation mediumeng
dc.subject.keywordsSurvivaleng
dc.subject.keywordsCorneaeng
dc.titleSobrevida libre de rechazo o falla en pacientes sometidos a queratoplastia penetrantespa
dc.type.driverinfo:eu-repo/semantics/other
dc.type.spaOtros
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