Long-term outcomes following primary versus secondary Boston keratoprosthesis type 1 implantation

2021 ◽  
pp. bjophthalmol-2020-317606
Author(s):  
Taylor Nayman ◽  
Cristina Bostan ◽  
Andrei-Alexandru Szigiato ◽  
Mona Harissi-Dagher
Keyword(s):  
Medical Records ◽  
Retention Rates ◽  
Primary Group ◽  
Long Term Outcomes ◽  
Boston Keratoprosthesis ◽  
Device Implantation ◽  
Corrected Visual Acuity

Background/aimsTo compare long-term outcomes of primary versus secondary (postgraft failure) Boston keratoprosthesis type 1 (KPro) implantation.MethodsMedical records of patients at the Centre hospitalier de l’Université de Montréal having undergone KPro implantation between 2008 and 2017 were reviewed and included if they had a preoperative Snellen best-corrected visual acuity (BCVA) of 20/100 or worse and a minimum of 5 years of follow-up. Eighty-two eyes were separated into two cohorts (40 primary, 42 secondary KPro) and BCVA, complications and device retention were evaluated between groups.ResultsBCVA improved from baseline in both groups at each year; this was significant at all five postoperative years in the primary group and the first 3 years in the secondary group (p<0.05). Mean BCVA was similar between groups at 5 years (logarithm of minimal angle resolution 1.3±0.8 in the primary group vs 1.5±0.8 p<0.05). Idiopathic vitritis, choroidal detachment and new glaucoma occurred more after primary KPro (n=7, 17.5% vs n=1, 2.4%; n=11, 27.5% vs n=3, 7.14% and n=14, 35% vs n=6, 14%, respectively; p<0.05). Primary KPro had lower retention (n=28, 70% vs n=38, 91%, p<0.05) at final follow-up. There was more aniridia in the primary group (n=19, 48% vs n=6, 14%, p<0.01). Within each group, 50% of removals occurred in aniridic eyes.ConclusionPrimary KPro yielded favourable long-term visual outcomes but had more complications and lower retention rates than secondary KPro, likely explained by preoperative indications. Primary device implantation represents a favourable option for patients for whom grafts are likely to fail.

Abstract 555: The Universal Clinical Classification of Acute Myocardial Infarction is a Better Predictor of Long Term Outcomes than ST Segment Classification

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Manuel A Gonzalez ◽  
Dana Eilen ◽  
Rana A Marzouq ◽  
Saed Awadallah ◽  
Hiren R Patel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Inverse Relationship ◽  
Long Term Outcomes ◽  
St Segment ◽  
Vascular Beds

Introduction: The universal classification (UC) of AMI aims to facilitate cross-study analysis, yet the long-term outcomes using UC are largely unknown. Hypothesis: We tested the hypothesis that the long-term outcome of patients with AMI is better predicted by UC than ST segment classification. Methods: We conducted a prospective study of 348 consecutive patients with AMI with mean follow-up of 30.6 months. The primary outcome was the major adverse cardiovascular events (MACE) [composite of all causes of mortality, recurrent AMI, and stroke]. Multivariate and survival analysis of MACE was performed. Results: The study population was STEMI=168, NSTEMI=180, Type 1=278, Type 2=55, Type 3=5, Type 4a=2, Type 4b=5, and Type 5=3. During follow-up 80 patients died, 31 had an AMI, and 7 had a stroke. UC correlates with the ST segment classification (p<0.005). MACE free survival was different for Type 1 and Type 2 (p=0.043), but not for STEMI and NSTEMI. There was a positive association between MACE and the quartile of peak Troponin, number of cardiovascular risk factors, and number of vascular beds affected, and an inverse relationship with the utilization of discharge cardiovascular protective medications (all p≤0.01). No such inverse relationship existed for Type 2. Conclusions: UC of AMI is a better long-term predictor of MACE. The quartile of peak Troponin levels, cardiovascular risk factors, and number of vascular beds affected are independent predictors of MACE, while cardiac medications protect against MACE, except in Type 2 patients.

scholarly journals Comparative Analysis of the Clinical Features and Long-Term Outcomes of Pachychoroid Neovasculopathy and Type 1 Neovascular Age-Related Macular Degeneration

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Jong In You ◽  
Kiyoung Kim
Keyword(s):  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Long Term Outcomes ◽  
Age Related ◽  
Treatment Naïve ◽  
History Of ◽  
Pachychoroid Neovasculopathy

Purpose. To evaluate the clinical characteristics and long-term prognosis of pachychoroid neovasculopathy (PCN) when compared with type 1 neovascular age-related macular degeneration (nAMD). Methods. We retrospectively analyzed 30 and 60 patients whose eyes were diagnosed as treatment-naïve PCN or type 1 nAMD, respectively. All subjects were followed up for 5 years. Baseline angiographic characteristics and long-term clinical outcomes were compared between the two groups. Results. PCN group consisted of patients of younger age and represented more choroidal vascular hyperpermeability, polypoidal lesion, and history of central serous chorioretinopathy (CSC) at the time of diagnosis (all p  < 0.01). During the 5-year follow-up period, individuals in the PCN group received significantly fewer injections and reported better visual acuity compared to individuals in the type 1 nAMD group. A progressive decrease in the subfoveal choroidal thickness was observed in the type 1 nAMD group, while the thick choroid was maintained in the PCN group during the 5-year follow-up period. Conclusions. PCN developed in younger patients with a higher propensity of forming polypoidal lesions and a history of CSC. Long-term outcomes revealed that PCN had a thicker choroid and better visual prognosis with fewer number of intravitreal injection than that of type 1 nAMD.

Gastric submucosal tumors: Lessons learned from 10-year follow-up

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15631-e15631
Author(s):  
A. Sawaki ◽  
N. Mizuno ◽  
T. Takagi ◽  
K. Hara ◽  
T. Nakamura ◽  
...  
Keyword(s):  
Medical Records ◽  
Surgical Intervention ◽  
Lessons Learned ◽  
Long Term Outcomes ◽  
Submucosal Tumors ◽  
Stromal Tumors ◽  
Gastric Submucosal Tumors ◽  
Simultaneous Surgery

e15631 Background: Gastric Submucosal tumors (SMTs) were incidentally discovered esophagogastroduodenoscopy (EGD). However, they have not been studied in detail of epidemiology. Furthermore, no treatment strategy for SMTs has been established with few studies looking into long-term outcomes. The aim of this study is to clarify the clinical features and long-term outcomes of gastric SMT at a single institute for 10-year period. Methods: We performed a total of 5307 EGDs and detected 188 gastric SMTs during 1998. All clinical data including incidence, size and location in stomach were analyzed for the medical records. A retrospective review was conducted for 10-year period for 109 patients and 79 patients were excluded because of simultaneous surgery (3), disappear in follow- up EGD (27), lost of follow-up (49). Results: Gastric SMTs were detected 188 (81 males, 107 females) of 5307 patients (3.5%). Majority size of SMTs was less than 1cm (64%) and SMTs<2cm were 91%. 56% of SMTs located middle one third of stomach, and half (22%) of the remaining SMTs were detected at upper and lower one third, respectively. In 10-year follow-up, 83 of 109 patients were alive at December 2008. One patient was dead of SMT and the remaining 25 patients were dead of other disease till December 2008. Enlargement of SMT was observed in 2 of 109 SMTs (1.8%). Both of them underwent surgical resection and diagnosed as gastrointestinal stromal tumors (GIST). One patient was annually monitored by endoscopy, from 0.6cm to 1.5cm during 4 years, without recurrence for 6 years after surgical intervention. Another didn't undergo regular endoscopy, from 1.8cm to 8cm during 2 years, with recurrence, and consequently died of SMT. Conclusions: The incidence of SMTs is 3.5%, majority (91%) is small (<2cm), and frequent location is middle one third of stomach. Most of SMTs might be managed conservatively, but regular endoscopy is required. No significant financial relationships to disclose.

scholarly journals Long-term outcomes of “open iridectomy” for secondary anterior chamber epithelial iris cysts

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jie Lan ◽  
Ting Liu ◽  
Yusen Huang ◽  
Xiaojing Pan ◽  
Yufen Wei ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Treatment Success ◽  
Corneal Edema ◽  
Long Term Outcomes ◽  
Corneal Incision ◽  
Clear Corneal Incision ◽  
Corrected Visual Acuity ◽  
Minimal Invasion

AbstractEpithelial cysts run a high risk of recurrence and conversion to sheet-like ingrowth after surgical intervention. In this retrospective study, we introduced a modified iridectomy for treatment of secondary epithelial iris cysts (EICs) in the anterior chamber. Twenty-nine patients (29 eyes) aged 2–61 years received “open iridectomy” for EICs between April 1995 and July 2019. After viscodissection, most of the cyst wall was cut using a 20-gauge aspiration cutter via a 2.5-mm clear corneal incision. The residue closely adhering to the iris stroma was remained to avoid photophobia and diplopia. At 3 months, best corrected visual acuity was ≥ 20/100 in 55.5% (15/27, except two pediatric patients with poor cooperation) of patients. Among the eight patients suffering partial corneal edema preoperatively, six patients received surgery treatment at 3–6.5 months, and the cornea in the other two patients became transparent after medication. In a mean follow-up of 47.4 months, recurrence occurred in 3 patients at 7, 37, and 118 months, respectively. The percentage of treatment success was 96%, 87%, and 65% at 1, 5, and 10 years, respectively. “Open iridectomy” was effective for EICs, with a minimal invasion, less damage to the corneal endothelium, and a low recurrence rate.

Abstract 351: Comparisons of a Pre- and Post-Behaviorally Modified Lifestyle Intervention for Reducing Cardiometabolic Risk in an Employee Population: My Unlimited Potential

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Ehimen Aneni ◽  
Sankalp Das ◽  
Chukwuemeka U Osondu ◽  
Henry Guzman ◽  
Joseph Mora ◽  
...  
Keyword(s):  
Lifestyle Intervention ◽  
Intervention Program ◽  
Behavioral Assessment ◽  
Retention Rates ◽  
Long Term Outcomes ◽  
Cvd Risk ◽  
Intensive Phase ◽  
Lifestyle Intervention Program

Background: A major shortcoming of lifestyle improvement programs has been the difficulty in understanding the recruitment and follow-up strategies that yield the best results in terms of targeted health outcomes and retention rates. In this study, we compare the retention rates, short and long-term outcomes of a tailored workplace lifestyle intervention program targeted at high CVD risk working populations before and after implementation of changes made to the program based on a behavioral assessment (BA) analysis. Methods: The My Unlimited Potential (MyUP) is a year long lifestyle intervention program conducted among high-CVD risk employees of Baptist Health South Florida. The program was initially designed to have a 9-week intensive phase, with a year long follow-up period. During the intensive phase, participants had supervised structured physical fitness training as well as nutritional counseling. Due to concerns about sub-optimal retention rates and outcomes, the program was modified based on the results of a behavioral assessment of the initial participants (see figure). An additional level of participant screening was introduced with the aim of recruiting those who were least likely to drop-out and most likely to succeed in the program. The program was also modified to have a 12-week intensive phase. Results: At all follow-up periods, the retention rate was higher among those in the post BA group (see table). Although persons in the post-BA group achieved significantly greater reduction in weight, BMI and body fat the absolute differences between groups was minimal. The measured reduction in systolic (SBP) and diastolic blood pressures (DBP) were greater in the pre-BA group at the end of the intensive phase but this was reversed by 1 year in which only those who received the revised intervention had sustained reduction in DBP. There was no significant between-group difference in the laboratory parameter changes, including HbA1c and hsCRP. Conclusion: Using a behavioral assessment modification module improves retention rates with minimal improvement in outcomes. BA modification should be used in programs with low retention rates but may be of minimal impact on long term outcomes.

Outcomes and risk factors for failure after trabeculectomy in Taiwanese patients: medical chart reviews from 2006 to 2017

2020 ◽  
pp. bjophthalmol-2020-317303
Author(s):  
Hsun-I Chiu ◽  
Huan-I Su ◽  
Yu-Chieh Ko ◽  
Catherine Jui-Ling Liu
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Medical Records ◽  
Success Rates ◽  
Long Term Outcomes ◽  
Kaplan Meier ◽  
Chinese Ethnicity ◽  
Preoperative Visual Acuity

AimsTo determine long-term outcomes and risk factors for failure after mitomycin C (MMC)-augmented initial trabeculectomy (IT) in Taiwanese patients.MethodsWe reviewed medical records of patients with glaucoma undergoing IT during December 2006–December 2016. We defined complete success as an intraocular pressure (IOP) of >5 or ≤21 mm Hg or IOP reduction of ≥20% from baseline without supplemental medications and qualified success as the aforementioned IOP levels with or without supplemental medications. Kaplan-Meier survival and Cox proportional analyses evaluated success rates and risk factors for failure, respectively.ResultsWe enrolled 190 patients (237 eyes; mean age: 54.0±15.3 years; mean postoperative follow-up period: 68.4±35.1 months). Mean IOP and glaucoma medications decreased from 22.2±10.8 to 14.4±5.2 mm Hg (p<0.001) and 3.0±0.7 to 1.8±1.2 (p=0.015), respectively, at the last visit. Cumulative qualified success rates were 93.9%, 93.0%, 86.5% and 67.1% at the 1, 2, 5 and 10 years follow-up, respectively; however, only 7.7% of the eyes reached complete success at the last visit. Eyes with poor preoperative visual acuity were associated with low qualified success rates (HR=1.689, p=0.027); patients aged >70 years had higher complete success rates than did those aged ≤70 years. Five cases (2.11%) exhibited bleb-associated complications.ConclusionDespite satisfactory long-term success rates, most eyes needed medication for IOP control, supporting the notion of predisposed scarring vitality in patients of Chinese ethnicity following MMC-augmented trabeculectomy.

scholarly journals Long-term outcomes of sleeve gastrectomy as a revisional procedure after failed gastric band: a multicenter cross-matched cohort study

2021 ◽  
Author(s):  
Francesco de Angelis ◽  
Cristian Eugeniu Boru ◽  
Angelo Iossa ◽  
Nicola Perotta ◽  
Fabio Cesare Campanile ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Gastric Band ◽  
Revisional Surgery ◽  
Control Group ◽  
Primary Group ◽  
Long Term Outcomes ◽  
Multicenter Cohort

AbstractLaparoscopic adjustable gastric band (LAGB) is the bariatric procedure most likely subject to revisional surgery. Both laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB) represent viable options, but the long-term results are still lacking. In 2014, we published the 2-year follow-up of our multicenter cohort of revisional LSG after failed LAGB. Evaluate the long-term follow-up (median 9.3 years) of the same cohort of patients. University and primary-care hospitals, Italy. We retrospectively examined a prospectively maintained database of the previously published multicenter cohort of 56 patients who underwent LSG after failed LAGB between 2008–2011. The control group included cross-matched non-revisional LSGs. The primary endpoint was weight loss, secondary endpoints co-morbidities, and the need for further bariatric surgery. The study group included 44 patients and the control group 56. We found %EWL 53% Vs. 67% (p = .021), %EBMIL (54 Vs. 68%, p = .018), %TWL (26 Vs. 34%, p = .002). We also found more severe GERD (gastroesophageal reflux disease) symptoms in the revisional than in the primary group (9.0 vs. 1.8% mild and 23.0 vs. 3.0% severe). Ten patients from the revisional group (22.7%) vs. eight in the primary group (13%) underwent further bariatric surgery (LRYGB). Our results showed less favorable weight loss in revisional than primary LSG after LABG, higher prevalence of GERD, and a more frequent need for further revisional surgery. Despite the study’s limitations, the present data suggest that the long-term outcomes may offset the possible reduced short-term complication rate after revisional sleeve gastrectomy for a failed LABG.

Periprocedural risk and long-term outcome of intracranial angioplasty based on a single-centre experience

VASA ◽  
2013 ◽  
Vol 42 (4) ◽  
pp. 264-274
Author(s):  
Dagmar Krajíčková ◽  
Antonín Krajina ◽  
Miroslav Lojík ◽  
Martina Mulačová ◽  
Martin Vališ
Keyword(s):  
Death Rate ◽  
Long Term Outcomes ◽  
Single Centre ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis ◽  
Angioplasty And Stenting ◽  
Aggressive Medical Management ◽  
Stroke Death

Background: Intracranial atherosclerotic stenosis is a major cause of stroke and yet there are currently no proven effective treatments for it. The SAMMPRIS trial, comparing aggressive medical management alone with aggressive medical management combined with intracranial angioplasty and stenting, was prematurely halted when an unexpectedly high rate of periprocedural events was found in the endovascular arm. The goal of our study is to report the immediate and long-term outcomes of patients with ≥ 70 % symptomatic intracranial atherosclerotic stenosis treated with balloon angioplasty and stent placement in a single centre. Patients and methods: This is a retrospective review of 37 consecutive patients with 42 procedures of ballon angioplasty and stenting for intracranial atherosclerotic stenosis (≥ 70 % stenosis) treated between 1999 and 2012. Technical success (residual stenosis ≤ 50 %), periprocedural success (no vascular complications within 72 hours), and long-term outcomes are reported. Results: Technical and periprocedural success was achieved in 90.5 % of patients. The within 72 hours periprocedural stroke/death rate was 7.1 % (4.8 % intracranial haemorrhage), and the 30-day stroke/death rate was 9.5 %. Thirty patients (81 %) had clinical follow-up at ≥ 6 months. During follow-up, 5 patients developed 6 ischemic events; 5 of them (17 %) were ipsilateral. The restenosis rate was 27 %, and the retreatment rate was 12 %. Conclusions: Our outcomes of the balloon angioplasty/stent placement for intracranial atherosclerotic stenosis are better than those in the SAMMPRIS study and compare favourably with those in large registries and observational studies.

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