Outcomes of Pars Plana Vitrectomy in Combination With Penetrating Keratoplasty

2017 ◽  
Vol 1 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Randee Miller Watson ◽  
Sherif Dawood ◽  
Dingcai Cao ◽  
William F. Mieler ◽  
Yannek I. Leiderman
Keyword(s):  
Pars Plana Vitrectomy ◽  
Graft Failure ◽  
Penetrating Keratoplasty ◽  
Silicone Oil ◽  
Corneal Transplantation ◽  
Corneal Graft ◽  
Minimum Angle ◽  
Pars Plana ◽  
Corneal Decompensation ◽  
Corneal Graft Failure

Purpose: To report indications and outcomes of combined pars plana vitrectomy and penetrating keratoplasty (PPV-PKP). Methods: A review of all patients who underwent PPV-PKP at the Illinois Eye and Ear Infirmary from January 1, 2001 to May 31, 2013, was performed. Ninety eyes of 90 patients were identified. Survival analysis was utilized to assess differences in retinal detachment (RD) and corneal graft failure rates among groups based on clinical and surgical variables. Results: Seventy-nine eyes met the inclusion criteria. Most common indications for vitrectomy and corneal transplantation were RD (65%) and corneal decompensation (43%), respectively. The preoperative and final visual acuity (VA) logarithm of the minimum angle of resolution values were 2.7 (0.31) and 2.5 (0.67) (hand motions; mean [SD]; P = .02); 15% of eyes were ≥20/400 and 15% gained ≥2 lines of vision following surgery. Corneal graft failure occurred in 51% (40 eyes), recurrent RD in 28% (22 eyes), and hypotony in 25% (20 eyes). Silicone oil endotamponade was associated with postoperative RD ( P = .045), and previous ocular trauma was associated with postoperative corneal graft failure ( P = .023). Conclusion: Combined PPV-PKP surgery was likely to achieve stabilization of VA, with a minority of eyes achieving modest gains in VA.

Tube Shunt Related Complications of the Cornea

2013 ◽  
Author(s):  
Nan Wang
Keyword(s):  
Anterior Chamber ◽  
Graft Failure ◽  
Corneal Transplantation ◽  
Corneal Edema ◽  
Corneal Graft ◽  
Visual Axis ◽  
Tube Extrusion ◽  
Pars Plana ◽  
Tube Shunt ◽  
Corneal Graft Failure

Tube shunts can be placed in the anterior chamber, the ciliary sulcus, or the pars plana. However, if the eye is phakic, the choice is limited to the anterior chamber; ciliary sulcus placement is likely to result in cataract formation, and pars plana placement will likely complicate removal of the cataract that will likely develop. Most corneal complications of tube shunt surgery result from tubes that are too anterior. Loss of vision may result due to these complications. If the tube is inadvertently inserted too close to the cornea, a loss of endothelial cells will result in edema and require transplantation to restore vision. Reported rates of corneal complications range from 2% to 33% and consist mostly of corneal edema/decompensation and corneal graft failure. In a cohort of patients implanted with the Ahmed™ Glaucoma Valve (New World Medical, Inc., Rancho Cucamonga, California), postoperative corneal abrasions occurred in 5 of 60 (8%) eyes. Another study reported the rate of corneal drying/dellen later in the postoperative course (8 of 59 eyes; 13.6%). Contact between the tube and the cornea has been noted at a rate of up to 5%. As the rate of tube shunt implantation has increased, the incidence of corneal edema in patients with tube shunts has also increased. Some of these cases develop corneal opacification with decreased vision and may require corneal transplantation to clear the visual axis. One large study of patients with Ahmed tube shunts (159 eyes total) reported corneal graft failure resulting in repeat penetrating keratoplasty (PKP) in 11 of 31 (35%) eyes with corneal grafts. Improper anterior chamber tube entry may damage the cornea. If the entry angle is not parallel to the iris and aims anteriorly, the needle used to create the tunnel may tear or detach Descemet’s membrane. Entry through the cornea (rather than the sclera) may also predispose to epithelial downgrowth or tube extrusion. To avoid such a complication, fullthickness entry into the anterior chamber should be as far posterior as possible.

Effectiveness of Histocompatibility Matching in High-Risk Corneal Transplantation

2020 ◽  
pp. 1-8
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
High Risk ◽  
Graft Failure ◽  
Corneal Transplantation ◽  
Corneal Graft ◽  
Hla Dr ◽  
Risk Patients ◽  
Graft Success ◽  
Group Matching ◽  
Corneal Graft Failure

The Collaborative Cornea Transplant Studies (CCTS) comprised two randomized, double-masked, clinical trials, the Antigen Matching Study (AMS) and the Crossmatch Study (CS), designed to determine whether matching HLA-A, -B, and/or HLA-DR antigens, donor-recipient crossmatching, or ABO compatibility reduced the risk of corneal allograft rejection and failure in high-risk patients. The studies showed that for patients needing a corneal graft with uncompromised immune systems and at high risk for corneal graft rejection: (1) neither HLA-A, -B, nor HLA-DR antigen matching substantially reduces the likelihood of corneal graft failure; (2) a positive donor-recipient crossmatch does not dramatically increase the risk of corneal graft failure; and (3) ABO blood group matching may be effective in reducing the risk of graft failure. Intensive steroid therapy after transplantation, frequent follow-up, medication and follow-up compliance, and patient education appear to play a significant role in corneal graft success.

Risk Factors for Corneal Graft Failure and Rejection in the Collaborative Corneal Transplantation Studies

Ophthalmology ◽  
1994 ◽  
Vol 101 (9) ◽  
pp. 1536-1547 ◽  
Author(s):  
Maureen G. Maguire ◽  
Walter J. Stark ◽  
John D. Gottsch ◽  
R. Doyle Stulting ◽  
Alan Sugar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Graft Failure ◽  
Corneal Transplantation ◽  
Corneal Graft ◽  
Corneal Graft Failure

scholarly journals Risk factors for corneal graft failure and rejection in penetrating keratoplasty

2001 ◽  
Vol 79 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Kenji Inoue ◽  
Shiro Amano ◽  
Tetsuro Oshika ◽  
Tadahiko Tsuru
Keyword(s):  
Risk Factors ◽  
Graft Failure ◽  
Penetrating Keratoplasty ◽  
Corneal Graft ◽  
Corneal Graft Failure

scholarly journals Graft Survival after Penetrating Keratoplasty in Cases of Trabeculectomy versus Ahmed Valve Implant

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Abdelhamid Elhofi ◽  
Hany Ahmed Helaly
Keyword(s):  
Mitomycin C ◽  
Graft Survival ◽  
Graft Failure ◽  
Penetrating Keratoplasty ◽  
Anterior Segment ◽  
Group Versus ◽  
Corneal Graft ◽  
Ahmed Glaucoma Valve ◽  
Significant Difference ◽  
Corneal Graft Failure

Purpose. To compare the corneal graft survival rates after penetrating keratoplasty (PKP) in cases of post-PKP glaucoma managed by either trabeculectomy with mitomycin C or Ahmed glaucoma valve (AGV). Methods. This study was a retrospective interventional comparative study that included 40 eyes of 40 patients. The included patients had undergone previous PKP for anterior segment reconstruction after microbial or fungal keratitis, chemical burns, trauma, or perforated corneal ulcer. Post-PKP glaucoma was managed surgically by either trabeculectomy with mitomycin C (group 1) or Ahmed glaucoma valve (group 2). Results. The first group n=20 had undergone trabeculectomy with MMC, and the second group n=20 had undergone AGV implantation. Regarding BCVA, there was no statistically significant difference between the 2 groups. Mean IOP was significantly lower in the AGV group at 6 months, 12 months, and 24 months p=0.001. Mean IOP at 24 months dropped significantly from preglaucoma surgery levels in both groups p=0.001. Rejection episodes occurred in 2 eyes (10%) of the trabeculectomy group versus 8 eyes (40%) in the AGV group p=0.028. In the trabeculectomy group, corneal graft failure occurred in 1 (5%), 3 (15%), and 6 (30%) eyes at 6 months, 12 months, and 24 months, respectively. In the AGV group, corneal graft failure occurred in 2 (10%), 5 (25%), and 10 (50%) eyes at 6 months, 12 months, and 24 months, respectively. The mean time to failure in the trabeculectomy group was 12.33 ± 5.60 months versus 11.90 ± 5.70 months in the AGV group p=0.027. Conclusion. Managing postpenetrating keratoplasty glaucoma could be bothersome especially in complex cases. Ahmed glaucoma valve implant controls the intraocular pressure more effectively than trabeculectomy with mitomycin C. However, Ahmed glaucoma valve can result in higher rates of corneal graft failure in a shorter duration of time. This trial is registered with PACTR201712002861391 on 21 Dec 2017.

scholarly journals Recurrent Intraocular Lens Dislocation in a Patient with Familial Ectopia Lentis

2021 ◽  
Vol 18 (9) ◽  
pp. 4545
Author(s):  
Tomasz K. Wilczyński ◽  
Alfred Niewiem ◽  
Rafał Leszczyński ◽  
Katarzyna Michalska-Małecka
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Vision Loss ◽  
Silicone Oil ◽  
Single Case ◽  
Recurrent Dislocation ◽  
Ectopia Lentis ◽  
Pars Plana ◽  
The Right

A 36-year-old patient presented to the hospital with recurrent dislocation of the intraocular lens (IOL). The patient with the diagnosis of familial ectopia lentis was first operated on for crystalline lens subluxation in the left eye in 2007 and in the right eye in 2009. In both eyes, lens extraction with anterior vitrectomy and transscleral fixation of a rigid IOL was performed. In 2011, the IOL in the right eye luxated into the vitreous cavity due to ocular trauma. The patient underwent a pars plana vitrectomy with the IOL resuturation to the sclera. Seven years later, a spontaneous vision loss in the right eye was caused by a retinal detachment. The pars plana vitrectomy with silicone oil tamponade and a consequential oil removal three months later were performed in 2018. The follow-up examination revealed recurrent IOL dislocation in the same eye. Due to a history of previous suture-related complications a decision was made to remove the subluxated rigid polymethyl-methacrylate (PMMA) IOL and fixate to sclera a sutureless SOLEKO FIL SSF Carlevale lens. The purpose of this report is to present a single case of a 36-year-old patient who was presented to the hospital with recurrent dislocation of the intraocular lens. In a three-month follow-up period, a good anatomical and functional outcome was finally obtained with transscleral sutureless intraocular lens. This lens is an option worth considering especially in a young patient with a long life expectancy and physically active.

Management of a case of Enhanced S-cone syndrome with massive foveoschisis treated with pars plana vitrectomy with silicone oil tamponade

2021 ◽  
pp. 1-4
Author(s):  
Lorane Bechet ◽  
Raphaël Atia ◽  
Christina Zeitz ◽  
Saddek Mohand-Saïd ◽  
José-Alain Sahel ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
Enhanced S Cone Syndrome
Sign in / Sign up

Export Citation Format

Share Document