scholarly journals The graft survival evaluation after subtotal penetrating keratoplasty in the long-term postoperative period

2017 ◽  
Vol 10 (3) ◽  
pp. 22-28 ◽  
Author(s):  
Nigina N Berdieva ◽  
Eleonora V Shapovalova ◽  
Inna A Riks
Keyword(s):  
Visual Acuity ◽  
Confocal Microscopy ◽  
Graft Survival ◽  
Postoperative Period ◽  
Penetrating Keratoplasty ◽  
Intraoperative Complications ◽  
Average Density ◽  
High Rate ◽  
Visual Functions

Introduction. Until the 2000s, in diseases leading to corneal blindness, it was expediently to perform subtotal keratoplasty in order to provide an organ-sparing effect and restore visual functions. Such procedures were not widely spread due to a great number of problems; they were performed with extended depressurization of the eye, and had a high risk of intraoperative complications. Nowadays, many ophthalmologists face the remote consequences of subtotal keratoplasty. Aim. The purpose is to evaluate the transplant after subtotal penetrating keratoplasty (SPK) and visual functions in the remote postoperative period. Materials and methods. We have examined 14 patients (14 eyes), aged from 28 to 81 years, at 6-10 years after SPK. Visual acuity (VA) testing, autorefractometry and confocal microscopy (Confoscan 4) were performed. Results. According to visual acuity testing results, patients were divided into 3 groups: 1st group with high VA (more than 0.2 - in 7.2% of patients), 2nd group with medium VA (from 0.2 to 0.005 - in 21.4% of patients), and 3rd - low VA (less than 0.005 - in 71.4% of patients). Before the SKP, VA was 0.004-0.7. After the SKP, the indices varied from light sensation with correct light projection to 1.0. High rate was in 21.5%, medium - in 35.7%, low in 42.8% of cases. According to autorefractometry data, the cylindrical component was in average 6.5 ± 3.0. Most often, astigmatism was revealed in the low (up to 3) and high degree (more than 6). According to confocal microscopy data, the average density of endothelial cells was 1700 ± 50 cells/mm2. Conclusion. More than a half of patients has preserved good visual functions and a transparent transplant at 6-10 years after the SKP, and this significantly improves the quality of patients´ life. (For citation: Berdieva NN, Shapovalova EV, Riks IA. The graft survival evaluation after subtotal penetrating keratoplasty in the long-term postoperative period. Ophthalmology Journal. 2017;10(3):22-28. doi: 10.17816/OV10322-28).

scholarly journals Visual Functions in Children in Remote Postoperative Period after Laser Treatment of Threshold Stages of Retinopathy of Prematurity

2018 ◽  
Vol 15 (2S) ◽  
pp. 18-23
Author(s):  
M. V. Pshenichnov ◽  
O. V. Kolenko ◽  
V. V. Egorov ◽  
E. L. Sorokin
Keyword(s):  
Visual Acuity ◽  
Postoperative Period ◽  
Retinopathy Of Prematurity ◽  
Vision Loss ◽  
State Institution ◽  
Laser Coagulation ◽  
Visual Functions ◽  
Functional Changes ◽  
Continuous Sampling ◽  
High Degree

Purpose.Analysis of visual functions in children in remote postoperative period after laser coagulation (LC) of threshold stages of retinopathy of prematurity (ROP).Patients and methods. In 2017, we selected and investigated 18 children, who previously had an LC of threshold stages of ROP in 2008–2009 in the Khabarovsk branch of the S.N. Fyodorov State Institution Eye Microsurgery Complex (continuous sampling method). There were 5 boys and 13 girls aged from 8 to 9 years at the time of LC. Anterior and posterior eye segments of the eyes (biomicroscopy, ophthalmoscopy), visual acuity, clinical refraction, concomitant pathology were evaluated.Results. We have revealed that regressive ROP after LC is characterized by the presence of serious anatomical and functional changes in the eyes. First, these are refractive disorders, which revealed in 90.5% of cases. Most often revealed: myopic refraction — 61% of all cases, of which more than half (53%) is its high degree; or its combination with compound myopic astigmatism (77% eyes); anisometropia was detected in 39% children. These refractive disorders led to the development of strabismus (61% children) and mixed amblyopia (60%). Despite the combined ophthalmologic pathology, 17% children developed visual functions with achievement of binocular vision, in most children visual functions still continue to develop, although they are not high due to amblyopia. High visual acuity (from 0.8 and above) in both eyes was formed in 22% children; visual acuity in the range of 0.5–0.7 in both eyes was formed in 17% children. Unfortunately, 44.5% children at the time of examination had low visual functions (in the range of 0.05–0.4) in both eyes. Extremely low visual acuity (from 0.01 to 0.04) in both eyes was identified in 11% children; absolute blindness in one of the eyes was in 11% children.Conclusions. LC is reliable way to prevent vision loss from retinal detachment in children with threshold stages of ROP. 

scholarly journals Simultaneous Penetrating Keratoplasty with Crescentic Inferior Keratoplasty in Advanced Pellucid Marginal Degeneration

2015 ◽  
Vol 4 (2) ◽  
pp. 60-62
Author(s):  
David Smadja ◽  
David Touboul ◽  
Valentine Saunier
Keyword(s):  
Visual Acuity ◽  
Surgical Technique ◽  
Penetrating Keratoplasty ◽  
Corneal Transplant ◽  
Long Term Outcomes ◽  
Postoperative Results ◽  
Junction Site ◽  
Biomechanical Parameters ◽  
Corneal Thinning

ABSTRACT Purpose To describe and report long-term outcomes of a surgical technique in advanced pellucid marginal degeneration (PMD) combining conventional central penetrating keratoplasty (PK) with an additional crescentic inferior keratoplasty, using a single corneal transplant. Results We report the case of a 55-year-old male patient, who underwent a customized sizing PK in his right eye for an advanced PMD, which combined a central PK with an additional crescentic inferior keratoplasty. The 1 year postoperative results show very good clinical outcomes, including visual acuity and biomechanical parameters, as well as tectonic outcomes, documented with high resolution optical coherence tomography (OCT) at the junction site between the two grafts. Conclusion Advanced PMD is a specifically challenging condition for keratoplasty due to an extreme peripheral corneal thinning. This surgical technique may facilitate inferior suturing and optimize the postoperative tectonic outcomes. How to cite this article Saunier V, Smadja D, Touboul D. Simultaneous Penetrating Keratoplasty with Crescentic Inferior Keratoplasty in Advanced Pellucid Marginal Degeneration. Int J Kerat Ect Cor Dis 2015;4(2):60-62.

scholarly journals Evaluation of Sutureless, Glueless, Flapless, Intrascleral Fixated Posterior Chamber Intraocular Lens in Children with Ectopia Lentis

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Kannan NB ◽  
Piyush Kohli ◽  
Bhanu Pratap Singh Pangtey ◽  
Kim Ramasamy
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Pediatric Population ◽  
Intraoperative Complications ◽  
Vitreous Hemorrhage ◽  
Posterior Chamber ◽  
Ectopia Lentis ◽  
Uncorrected Visual Acuity ◽  
Posterior Chamber Intraocular Lens

Aim. This paper aims at evaluating refractive outcome and complication profile of sutureless, glueless, flapless, intrascleral fixation of intraocular lens (SFIOL) in pediatric population. Methods. This retrospective study included patients ≤18 years of age who underwent SFIOL for ectopia lentis. Details obtained included preoperative uncorrected visual acuity (UCVA), cycloplegic refraction, and best-corrected visual acuity (BCVA); intraoperative complications; and postoperative UCVA, cycloplegic refraction, and BCVA and complications. Results. Median pre- and postoperative UCVA was logMAR 1.78 (Snellen 20/1200) and logMAR 0.30 (Snellen 20/40), respectively, (p<0.001). Median pre- and postoperative BCVA was logMAR 0.24 (Snellen 20/34) and logMAR 0.18 (Snellen 20/30), respectively. UCVA ≥20/60 was attained in 90% of eyes. BCVA ≥20/30 was attained in 85.0% of eyes. Most common early postoperative complications were hyphaema (10%), transient vitreous hemorrhage (2.5%), and ocular hypotony (2.5%). None of these developed any long-term sequelae. Only one case of subluxation of IOL was seen. No case of late endophthalmitis or retinal detachment was seen. Conclusion. Since refractive error induced is minimal, the procedure is suitable for IOL implantation in children, who are noncompliant with spectacles. The complication profile is similar to that reported in adults.

scholarly journals Clinical Outcomes of Penetrating Keratoplasty and Descemet Stripping Automated Endothelial Keratoplasty in Asian Population with American Corneas

2019 ◽  
Vol 16 (22) ◽  
pp. 4547 ◽  
Author(s):  
Hsiao ◽  
Chen ◽  
Meir ◽  
Tan ◽  
Hsiao ◽  
...  
Keyword(s):  
Survival Rate ◽  
Graft Survival ◽  
Penetrating Keratoplasty ◽  
Survival Rates ◽  
Asian Population ◽  
Chang Gung Memorial Hospital ◽  
Endothelial Keratoplasty ◽  
Significant Difference ◽  
Donor Corneas

To determine the comparative efficacy and safety of penetrating keratoplasty (PK) and Descemet stripping automated endothelial keratoplasty (DSAEK) in the Asian population receiving imported donor corneas, our single-center retrospective study provides analysis supporting the transition from PK to DSAEK in the Asian population using imported American donor corneas. We analyzed 259 patients with 241 and 57 cases of PK and DSAEK respectively during 2008 to 2017 using imported corneas at Chang Gung Memorial Hospital, Linkou, Taiwan. In terms of long-term graft survival analysis, there was no difference between PK and DSAEK (log-rank p = 0.386, HR = 0.920, 95% CI: [0.641–1.380]). However, Cox proportional regression analysis revealed that corneal survival rate of DSAEK group in the first 100 days after transplantation was inferior than that of PK group (log-rank p < 0.001, HR = 2.733, 95% CI: [1.501–4.977])]. Despite the inferior survival rate, there were significantly less neovascularization and Descemet membrane folds in the DSAEK group. Importantly, the non-complication rate of DSAEK was much higher than that of PK with significant difference (PK, 25.7% vs DSAEK 42.0%, p = 0.022). Collectively, DSAEK is suggested as an alternative surgical modality in Asian patients using imported American donor corneas because of less complication, and no difference in long-term corneal graft survival rates between PK and DSAEK.

scholarly journals Bilateral Progressive Idiopathic Annular Lipid Keratopathy

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Ramon C. Ghanem ◽  
Vinícius C. Ghanem ◽  
Gustavo Victor ◽  
Milton Ruiz Alves
Keyword(s):  
Visual Acuity ◽  
Family History ◽  
Confocal Microscopy ◽  
Blood Vessels ◽  
Penetrating Keratoplasty ◽  
Ocular Trauma ◽  
Case Reports ◽  
Systemic Disease ◽  
Topical Steroids ◽  
Cholesterol Crystals

Purpose. To report two unusual cases of idiopathic lipid keratopathy with symmetrical bilateral annular corneal lipid infiltration and describe confocal microscopy findings.Methods. Case reports.Results. We report two patients with bilateral peripheral deep stromal lipid deposits beginning in an arcuate pattern and progressing to a complete annular shape. Cholesterol crystals were observed in the paracentral area in both cases with characteristic crystalline-like structures in the confocal microscopy. Deep thin corneal blood vessels were observed in one patient, but no cause for then was established, despite decades of followup. This patient had an idiopathic limbitis as well, occurring in episodes. No previous ocular trauma, systemic disease or family history was reported for both cases.Conclusion. These two cases of idiopathic annular lipid keratopathy were observed for more than a decade with documented slow and insidious progression of the infiltrates, in spite of the use of topical steroids in one case. In the majority of other reported cases, a penetrating keratoplasty was made necessary. Differently, we showed that the visual acuity can remain quite good for years with very slow deterioration.

scholarly journals The results of reconstructive penetrating keratoplasty in the children

2016 ◽  
Vol 11 (4) ◽  
pp. 192-195
Author(s):  
Alla Vyacheslavovna Pleskova ◽  
E. V Mazanova
Keyword(s):  
Graft Survival ◽  
Postoperative Period ◽  
Penetrating Keratoplasty ◽  
Functional Results ◽  
Early Postoperative Period ◽  
Corneal Transplant ◽  
Fold Reduction ◽  
Corneal Opacities ◽  
The Difference ◽  
One Year

Objective. To evaluate the immediate and long-term biological and functional results of reconstructive penetrating keratoplasty (RPKP) in the children. Materials and methods. We undertook a comparative analysis of the outcomes of 86 cases of the surgical intervention on 74 children presenting with corneal opacities of different etiology who had been treated with the application of reconstructive penetrating keratoplasty based at the Department of Eye Pathology in Children, The Helmholtz Moscow Research Institute of Eye Diseases. All operations were made by the same surgeon during the period from 2008 to 2014. The results of reconstructive penetrating keratoplasty were compared with the outcomes of conventional penetrating keratoplasty. The biological results were evaluated in terms of the graft survival (Kaplan-Meir’s) model. The duration of the postoperative follow-up period ranged from 5 months to 8 years and averaged 20,8 ± 9,7 months in the children treated with the use of reconstructive penetrating keratoplasty and to 3,0 ± 15,4 months in the patients treated by means of conventional penetrating keratoplasty. Results. During the early postoperative period (within 1 and 6 months after surgery), the difference in the graft survival rate between the two groups was practically non-existent. After 1 month, the transparency of the transplanted cornea was fairly well preserved in the children of both groups, but persisted for 6 months only in 72% and 95% of the patients treated by reconstructive and conventional penetrating keratoplasty respectively. One year after surgery, the graft survival in the children treated with the use of reconstructive penetrating keratoplasty was documented in 54% of the cases in comparison with 78% in the patients treated by means of conventional penetrating keratoplasty. The difference between the two groups was statistically significant (p < 0,05). Two and three years after surgery, the transparency of the transplanted cornea in the children treated with the use of reconstructive penetrating keratoplasty fell down to 50% and 20% respectively. During the same periods, the transparency of the transplanted cornea in the children treated by means of conventional penetrating keratoplasty remained as high as 76% and 62% respectively. Conclusion. Although the combination of penetrating keratoplasty with other surgical modalities results in the almost three-fold reduction of the probability of engraftment of the transparent corneal transplant in the remote postoperative period in comparison with the standard implantation of the donor cornea transplant, this operation provides the only possibility for the restoration of vision in the children suffering from severe corneal pathology.

scholarly journals TYPE OF FUNDOPLICATION FOR LAPAROSCOPICHIATAL HERNIA REPAIR, COMPLICATED BY GASTROESOPHAGEAL REFLUX DISEASE

2021 ◽  
pp. 29-39
Author(s):  
A. G. Grintcov ◽  
R. V. Ishenko ◽  
I. V. Sovpel ◽  
I. E. Sedakov ◽  
O. V. Sovpel ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Hiatal Hernia ◽  
Postoperative Period ◽  
Reflux Disease ◽  
Intraoperative Complications ◽  
Early Postoperative Period ◽  
Long Term Outcomes

Purpose. To analyze short-term and long-term outcomes of surgical treatment of the patients with hiatal hernia complicated by gastroesophageal reflux disease, depending on the choice of fundoplication method.Materials and methods. A retrospective analysis of the short and long-term outcomes of the treatment of 171 patients suffering hiatal hernia complicated by gastroesophageal reflux disease was performed. All patients were underwent laparoscopic hiatal hernia repair supplemented by Nissen fundoplication - 109 patients or Toupet fundoplication – 62 patients.Results. In the Nissen fundoplication group the incidence of intraoperative complications was 9.2% (11 patients), postoperative complications – 8.3% (9 patients), dysphagia in the early postoperative period was noted in 24 (22%) patients. In 5 years after surgery, gastroesophageal reflux was observed in 6 (5.5%) patients, anatomical recurrence in 13 (11.9%) patients. Dysphagia in the late postoperative period was noted in 7.3% (8 patients). In the Toupet fun doplication group the incidence of intraoperative complications was 11.3% (7 patients), the incidence of postoperative complications was 6.5% (4 patients), functional dysphagia in the early postoperative period was noted in 8 (12.9%) patients. In 5 years after surgery, gastroesophageal reflux was observed in 8 (12.9%) patients, anatomical relapse in 13 (11.9%) patients. Persistent long-term dysphagia in the late postoperative period was noted in 2(3.2%) patients.Findings. The choice of fundoplication method did not significantly affect on the duration of surgery, the frequency of intraoperative and postoperative complications, duration hospital stay, the incidence of early functional postoperative dysphagia, the number of unsatisfactory results in the long term period, including recurrence and dysphagia.

Long-term intraocular pressure after combined trabeculotomy-trabeculectomy in glaucoma associated with Sturge-Weber syndrome

2017 ◽  
Vol 28 (2) ◽  
pp. 210-215 ◽  
Author(s):  
Devindra Sood ◽  
Aanchal Rathore ◽  
Ishaana Sood ◽  
Dinesh Kumar ◽  
Narender N. Sood
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Vision Loss ◽  
Intraoperative Complications ◽  
Repeat Surgery ◽  
Antiglaucoma Medication ◽  
Weber Syndrome ◽  
Sturge Weber Syndrome

Purpose: Vision loss in Sturge-Weber syndrome (SWS), a rare congenital disorder, is primarily due to glaucoma. Methods: We reviewed the data of all consecutive SWS-associated glaucoma cases in patients who had undergone combined trabeculotomy-trabeculectomy (CTT) at a tertiary glaucoma facility between January 1993 and December 2015. We analyzed the preoperative and postoperative intraocular pressure (IOP), corneal clarity, visual acuity, success rate, need for repeat surgery, and number of topical antiglaucoma medications needed at last follow-up. Results: Twenty-six eyes of 20 patients with SWS (surgical age 0.7-96 months; mean 18.64 ± 29.74 months) had undergone primary CTT. The mean preoperative IOP was 32.76 ± 7.86 mm Hg (range 22-54 mm Hg) with medication (mean 3.11 ± 1.17; range 1-5). At the last follow-up (61-288 months); mean SD 134.73 ± 67.77 months), two eyes had IOP <6 mm Hg. Twenty-four eyes analyzed had an IOP of 13.63 ± 6.11 (mean ± SD; range 9-41) mm Hg. All these had an IOP <15 mm Hg at last follow-up except one, which had an IOP of 41 mm Hg. There was a mean reduction of 54.62% ± 31.33% in IOP from baseline. The antiglaucoma medication score at last follow-up visit was 0-3. No eye achieved predefined complete success or modified complete success. A total of 41.7% (10/24) of eyes attained both qualified and modified qualified success. Eleven eyes needed repeat surgeries. No intraoperative complications were noted. Visual acuity was below 6/60 in four eyes. Conclusions: Combined trabeculotomy-trabeculectomy showed promising results as a treatment for SWS-associated glaucoma in children. Long-term visual and surgical outcomes are encouraging.

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