scholarly journals Total Penetrating Keratoplasty: Indications, Therapeutic Approach, and Long-Term Follow-Up

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Katarzyna Krysik ◽  
Ewa Wroblewska-Czajka ◽  
Anita Lyssek-Boron ◽  
Edward A. Wylegala ◽  
Dariusz Dobrowolski

Purpose. Evaluation of the indications, anatomical and functional results, and complications of total penetrating keratoplasty (TPK) in disorders involving whole cornea. Materials and Methods. We analyzed outcomes of the surgical treatment of 47 eyes of 46 patients that underwent TPK. Indications were infectious keratitis, autoimmune disease, injury of the eyeball (mainly chemical burns), and other combined disorders. The surgical technique involved dissection of affected tissues with a margin of 1.0 mm. The size of the corneal graft ranged from 10.0 to 14.0 mm. We analyzed indications, outcomes, and complications of surgery. Results. Final restoration of the ocular integrity and maintenance of the globe were achieved in 27 eyes (57%). More than one surgery was necessary in a total of 29 eyes (62%). The frequency of retransplantations did not vary significantly between the groups with different causes of corneal melting/perforation (63% of eyes with infection, 66% of eyes after trauma and 70% of eyes of patients with autoimmune disorders). Surgical treatment failed in 20 eyes (43%). Evisceration was necessary in 13 eyes (28%), phthisis occurred in 7 cases (15%). Conclusion. TPK should be considered as a last line treatment in huge corneal destruction to restore integrity of the eye globe.

Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 310
Author(s):  
Maurizio De Pellegrin ◽  
Lorenzo Marcucci ◽  
Lorenzo Brogioni ◽  
Giovanni Prati

Moebius syndrome (MS) is a rare disease, with paralysis of the VI and VII cranial nerves, frequently associated with clubfoot (CF). The aim of this study was to evaluate surgical treatment of CF in MS, providing its peculiarities. Between 1990 and 2019, we collected data of 11 MS patients with unilateral (n = 5) or bilateral (n = 6) CF, for a total of 17 feet (9R,8L). Six patients (3M,3F) for a total of 10 feet (6R,4L) were treated elsewhere, performing first surgery at an average age of nine months, and in our hospital for relapse surgery at an average age of 4.5 years (Group 1). Five patients (3M, 2F), for a total of seven feet (3R,4L), were primarily treated in our hospital with a peritalar release according to McKay at an average age of 9.4 months (Group 2). Diméglio score was used to assess CF severity. Three questionnaires were submitted for evaluation of subjective and functional results: American Orthopedics Foot and Ankle Society for Hindfoot (AOFAS), Foot and Ankle Outcome Score (FAOS), and Foot and Ankle Ability Measure (FAAM). Average AOFAS/FAOS/FAMM scores were 82.8, 84.8, and 82.3 for Group 1, and 93.2, 94.7, and 95.1 for Group 2 at an average follow-up of 16.9 and 13.3 years, respectively. The average Diméglio score improved from 15.5 to 4.8 in the long-term follow-up in Group 1 and from 14.6 to 3.8 in Group 2. The comparison between the groups showed better results for AOFAS, FAOS, and FAAM scores for Group 2, particularly for pain, function, and foot alignment and for the post-surgical Diméglio score. CF in MS is more severe and presented a higher relapse rate (58.8%) than idiopathic CF. Peritalar release showed no relapse and better subjective and functional results in the long-term follow-up compared to other surgical techniques


2013 ◽  
Vol 22 (10) ◽  
pp. e36
Author(s):  
Paolo Paladini ◽  
Giovanni Merolla ◽  
Francesco Fauci ◽  
Fabrizio Campi ◽  
Giuseppe Porcellini

Author(s):  
Michele Fiore ◽  
Andrea Sambri ◽  
Carlotta Calamelli ◽  
Riccardo Zucchini ◽  
Claudio Giannini ◽  
...  

2017 ◽  
Vol 41 (5) ◽  
pp. 1242-1243 ◽  
Author(s):  
Alessandro Innocenti ◽  
Dario Melita ◽  
Francesco Ciancio ◽  
Marco Innocenti

2008 ◽  
Vol 141 (4) ◽  
pp. 512-516 ◽  
Author(s):  
Rakesh Popat ◽  
Heather E. Oakervee ◽  
Simon Hallam ◽  
Nicola Curry ◽  
Liz Odeh ◽  
...  

Eye ◽  
1996 ◽  
Vol 10 (1) ◽  
pp. 133-137 ◽  
Author(s):  
Paul B Chell ◽  
Monique W Hope-Ross ◽  
Peter Shah ◽  
Peter J McDonnell

2017 ◽  
Vol 39 (2) ◽  
Author(s):  
Antonio Marte ◽  
Lucia Pintozzi

The aim of this study was to verify the validity, feasibility, and the functional results, by uroflowmetry, of Tubularized proximallyincised plate technique in selected case of distal/midshaft hypospadias. Out of 120 patients scheduled to undergo TIP (or Snodgrass) procedure, 23 were selected between January 2013 and January 2016 (19.1%). This case series comprised 16 patients with distal and 7 with midshaft hypospadias. Mean age at surgery was 2.9 years. The inclusion criteria were a deep and wide glandular groove and a proximal narrow urethral plate. The procedure was carried out as described by Snodgrass but the incision of the urethral plate, including the mucosal and submucosal tissue, was made only proximally, between the original meatus and the glandular groove in no case extending to the entire length of the plate. Postoperatively a foley catheter was left in place from 4 to 7 days. Uroflowmetry was performed when the patients age ranged from 2.5 to 5.7 years (mean age 3.11 years and mean follow-up 1.8 years, body surface 2). No patient presented fistulas nor perioperative complications. At uroflowmetry, eighteen patients presented values above the 25<sup>th</sup> percentile and 5 showed a borderline flow. All patients in this group remained stable without urinary symptoms. In selected cases, the tubularized proximally-incised plate yields satisfactory cosmetic and functional results for the treatment of midshaft proximal hypospadias. A long-term follow-up study is needed for further evaluation. Patient selection is crucial for the success of this technique.


e-CliniC ◽  
2020 ◽  
Vol 8 (2) ◽  
Author(s):  
Richardo J. Laloan ◽  
Andreissanto C. Lengkong

Abstract: Congenital talipes equinovarus (CTEV) is a type of foot deformities characterized with hindfoot varus, adducted metatarsus, wide arched of the foot (cavus), and equinus. Its incidence is 1.2% per 1000 births annually. Around 80% of cases occur as idiopathic type and the remaining 20% is associated with other anomaly conditions. Genetic component is considered to play a role in the occurrence of CTEV. However, up to this day, there is no exact underlying etiology that defines the exact pathogenesis of CTEV. The evolving etiology nowadays is still multifactorial. Management of CTEV varies from non-surgical treatment to surgical treatment. A number of scoring and grading using qualitative and quantitative measurement are being used nowadays to assess the severity of CTEV because this deformity needs long-term follow-up due to its tendency to relapse.Keywords: congenital talipes equinovarus, clubfoot Abstrak: Congenital talipes equinovarus (CTEV), dikenal juga dengan true clubfoot, merupakan deformitas pada kaki yang ditandai oleh adanya bentuk varus kaki belakang, adduksi metatarsus, dan adanya bentuk lengkungan kaki yang lebar (cavus) serta equinus. CTEV merupakan salah satu dari deformitas kaki pada saat lahir dengan insidensi 1,2% per 1000 kelahiran hidup per tahunnya. Pada 80% kasus terjadi secara idiopatik dan 20% dikaitkan dengan kondisi-kondisi lain. Komponen genetik diduga berperan pada CTEV, namun, sampai saat ini, belum ada etiologi pasti yang menjelaskan patogenesis CTEV. Etiologi yang berkembang sampai saat ini bersifat multifaktorial. Tatalaksana pasien CTEV bervariasi mulai dari non-operatif maupun operatif. Sejumlah pengukuran kualitatif maupun kuantitatif telah dikembangkan untuk menilai keparahan CTEV berhubung kondisi deformitas ini membutuhkan follow-up jangka panjang karena mempunyai kecenderungan untuk relaps.Kata kunci: congenital talipes equinovarus, clubfoot


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