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.

Renal Transplantation—A Tale of Two Cities

1980 ◽  
Vol 25 (4) ◽  
pp. 269-274
Author(s):  
R. F. M. Wood ◽  
P. R. F. Bell ◽  
J. Walls ◽  
J. R. Nash ◽  
D. S. MacPherson ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Survival Rate ◽  
Graft Survival ◽  
Initial Experience ◽  
Tissue Typing ◽  
Two Cities ◽  
Transplant Team ◽  
The Difference ◽  
One Year ◽  
The One

In 1974 three members of the transplant team from the Western Infirmary in Glasgow moved to the new medical school in Leicester. The initial experience with 33 patients transplanted in Glasgow was published in 1972 and this paper compares the results of that series with the first 21 patients grafted in Leicester. Despite improvements in tissue typing, better quality donor kidneys and fewer complications, there has been a failure to improve on the levels of graft survival. The overall one year graft survival rate in the Glasgow series was 79 per cent compared to 52 per cent in Leicester. In these two series the difference in results appears to be explained by blood transfusion. All the Glasgow patients had been poly-transfused but of the Leicester patients the 10 transfused pre-transplant had a one year graft survival of 90 per cent while in the 11 non-transfused patients the one year graft survival was only 18 per cent.

scholarly journals Unicompartmental Knee Arthroplasty: Short-Term Results

2021 ◽  
Vol 27 (1) ◽  
pp. 153-165
Author(s):  
V. Yu. Murylev ◽  
N. E. Erokhin ◽  
P. M. Elizarov ◽  
G. A. Kukovenko ◽  
A. V. Muzychenkov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Outcome ◽  
Postoperative Period ◽  
Functional Results ◽  
Early Postoperative Period ◽  
X Rays ◽  
Operating Technique ◽  
Sf 36 ◽  
The Face

Background. Among the methods of surgical treatment of early stages medial knee osteoarthritis in the partial knee replacement (PKR) becomes more and more relevant. The relevance and increasing number of PKR are confirmed by data from various national registers.The aim of the study was to research the early functional results of PKR and to analyze the complications at various stages of the postoperative period.Material and Methods. Study design: a single-center prospective study. The results of 90 operations of PKR in the period from March 2018 to April 2020 are presented. Assessment of knee function and quality of life of patients was performed according to three scalesquestionnaires: KOOS, WOMAC, SF-36, which were filled in preoperatively and then at 3, 6, 9, 12, 18 months. after surgery. Patients within the reporting period provided X-rays and filled in the scales at the face-to-face examination and at remote contact.Results. The most significant improvement of quality of life and median values of the functional results observed after 3 months, and after 18 months. After replacement the best median functional outcome scales KOOS, WOMAC, SF-36 — 79,4 (73,6–84,3); 27,1 (24,8–30,6); 89,1 (85,3–92,6) compared with the functional results obtained before surgery 32,3 (22,8–38,4); 73,6 (63,6–78,8); 35,2 (31,3–42,1); p = 0,027; p = 0.023; p = 0,028, respectively. A negative correlation was obtained between BMI and functional outcome (p = 0.027, R = -0.7).Conclusion. PKR allowed us to achieve an improvement in the quality of life and functional results already in the early postoperative period (from 3 to 18 months after the operation). The improvement of the operating technique, the analysis of errors and the regularity of the performed PKR will improve the results of PKR and minimize the number of complications.

scholarly journals Outcome of fat injection in treatment of retracted scars

2019 ◽  
Vol 6 (9) ◽  
pp. 3195
Author(s):  
Fobin Varghese ◽  
Ajayakumar Kochunarayanan ◽  
Aneesh Joseph ◽  
Kalesh Sadasivan
Keyword(s):  
Normal Skin ◽  
Functional Results ◽  
Fat Grafting ◽  
P Value ◽  
Fat Injection ◽  
Post Surgery ◽  
Scar Assessment ◽  
The Difference ◽  
One Year ◽  
Different Origins

Background: Fat grafting was developed in recent years with refinement mainly based on Coleman technique. The method consists of taking fat removed by liposuction under low pressure, fat processing and then placement of fat on the treated area.Methods: Patients who presented with depressed or retracted scars were considered. 12 patients were selected for the study as one year. Patients were given fat injection by Coleman’s technique and were evaluated at 1, 3 and 6 months. Patient and observer scar assessment score (POSAS) was used for evaluation.Results: The present study infers that there is a significant decrease in POSAS score on both the patient and observer side after fat injection for retracted scars. The overall patient score decreased from 5.75 (±0.866 SD) pre-operatively to 3.17 (±1.115 SD) post-operatively with a p value of less than 0.005. The difference between the scores is 2.58 which are comparable to other studies. The overall observer score decreased from 4.25 (±1.422 SD) pre-operatively to 2.58 (±0.996) post-operatively with a p value of less than 0.005. The difference between the scores is 1.67 which is comparable to other studies.Conclusions: Autologous fat grafting seems to be a promising and effective therapeutic approach for scars with different origins such as trauma, burns, post-surgery. In general, we can affirm that treated areas regain characteristics similar to normal skin, which are clinically perceptible, leading not only to aesthetic but also functional results. 

scholarly journals Oral prednisolone administration in postoperative period improves results of TKA in patient with severe range of motion limitation – a paired outcome study

2020 ◽  
Author(s):  
Dariusz Grzelecki ◽  
Jacek Kowalczewski ◽  
Bartłomiej Kordasiewicz ◽  
Marcin Sibinski ◽  
Łukasz Olewnik ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Postoperative Period ◽  
Oral Prednisolone ◽  
Functional Results ◽  
Clinical Score ◽  
Limited Range ◽  
Functional Score ◽  
Limited Range Of Motion ◽  
Postoperative Time ◽  
One Year

Abstract Background One of the most common problems related to total knee arthroplasty (TKA) is postoperatively limited range of motion, especially in the most difficult cases. The aim of the study was to assess the influence of oral use of prednisolone in the postoperative period on the final results in a patient after TKA with severely limited postoperative range of motion. Methods Thirty-two patients (32 knees) with a mean age of 61.2 years were selected from our prospectively-collected data base with severe knee range of motion limitation (rheumatoid arthritis, psoriasis, ankylosing spondylitis, posttraumatic and postoperative osteoarthritis). Prednisolone was administrated in two doses per day (1 mg per kg of body mass) and then the dose was slowly reduced for no more than three months. Results The prednisolone group demonstrated significantly better results one year after the operation than the non-prednisolone group in terms of range of motion (mean extension 0.5˚ and 3.0˚; p=0.02, mean flexion 100.1˚ and 88˚; p= 0.01), WOMAC (mean 85.0 and 76.8 points; p=0.02) and KSS clinical score (mean 86.9 and 81.7; p=0.001) and KSS functional score (79.3 and 71.0 points; p=0.01). No significant differences were observed between the groups in terms of postoperative systemic and surgical site complications; therefore, no complications could be defined as steroid related. Conclusions The administration of oral prednisolone for a longer postoperative time in patients with severe preoperative range of motion following TKA significantly improves functional results without steroid related complications at one year follow-up.

Ten-Year Survival of Optical Penetrating Keratoplasty and Risk Factors for Graft Failure in Thai Patients

2020 ◽  
Vol 103 (9) ◽  
pp. 883-890
Keyword(s):  
Risk Factors ◽  
Graft Survival ◽  
Graft Failure ◽  
Penetrating Keratoplasty ◽  
Significant Risk ◽  
Visual Outcome ◽  
Successful Outcome ◽  
Bullous Keratopathy ◽  
One Year

Objective: To determine long-term graft survival and identify risk factors for secondary graft failure of optical penetrating keratoplasty (PK) in Thai patients. Materials and Methods: A Retrospective study of patients that underwent optical PK at Siriraj Hospital between January 2002 and December 2005 was done. Results: Of 131 eyes, primary graft failure was found in two eyes (1.5%) thus, 129 eyes were recruited. The three most common surgical indications were pseudophakic or aphakic bullous keratopathy (33.3%), corneal scars (post-trauma, post-infection) (20.9%), and regrafts (16.3%). Mean follow-up period was 93.2 months (1 to 183 months). One-year, 2-year, 5-year, and 10-year graft survival rates were 84.5%, 73.2%, 50.2%, and 24.7%, respectively. The leading cause of graft failure was irreversible allograft rejection (62.5%). Most (56.0%) of the first graft rejection happened within one year post-operatively. Graft survival was lower in eyes with regrafts, history of glaucoma, deep corneal vascularization, peripheral anterior synechiae, and occurrence of one or more rejection episodes. Multivariate regression analysis demonstrated that peripheral anterior synechiae and occurrence of one or more rejection episodes were the significant independent risk factors for graft failure. Considering patients with the clear grafts at the last follow-up, the final best-corrected visual acuity was 6/36 or better in 66.7% eyes and 6/18 or better in 31.6% eyes. Comparing to pre-operative vision, patients with the clear grafts at the last follow-up had improved visual outcome in most eyes (82.5%). Conclusion: Ten-year survival and visual outcome of optical PK showed successful outcome, however, the survival rate decreased over time. The significant risk factors for graft failure should be cautiously evaluated before surgery. Keywords: Corneal graft survival, Keratoplasty outcome, Optical penetrating keratoplasty

scholarly journals Symptomatic Fourth Ventricle Arachnoid Cyst Extending to the Upper Border of the Dens of the Axis: A Case Report and Review of the Literature

2014 ◽  
Vol 2 (2) ◽  
pp. 299-302
Author(s):  
Salih Gulsen
Keyword(s):  
Case Report ◽  
Arachnoid Cyst ◽  
Postoperative Period ◽  
Fourth Ventricle ◽  
Early Postoperative Period ◽  
Arachnoid Cysts ◽  
Review Of The Literature ◽  
One Year ◽  
Walking Difficulty

Arachnoid cysts are congenital and non-tumorous intra-arachnoid fluid accumulations that make up about 1% of all intracranial space. occupying lesions. We report a patient with a fourth ventricle arachnoid cyst extending to the upper border of the dens of the axis. This patient progressively developed walking difficulty and stiffness in his legs together with difficulty in grasping objects with his hands within one year. The cyst was totally excised and the patient's symptoms improved in the early postoperative period, but he developed intraventricular and intracisternal air which was followed-up conservatively and resolved spontaneously.

scholarly journals Penetrating Keratoplasty For Treatment Of Bullous Keratopathy

2015 ◽  
Vol 8 (2) ◽  
pp. 133-136
Author(s):  
Snezhana V. Murgova ◽  
Chavdar B. Balabanov
Keyword(s):  
Postoperative Period ◽  
Penetrating Keratoplasty ◽  
Early Postoperative Period ◽  
University Hospital ◽  
Bullous Keratopathy ◽  
Additional Risk ◽  
Early Postoperative Complications ◽  
Important Complication ◽  
Late Postoperative Period ◽  
Eye Clinic

Summary The aim of the retrospective study was to analyze results after penetrating keratoplasties in patients with bullous keratopathy. The study included 60 patients with bullous keratopathy who underwent penetrating keratoplasty for the period 1990-2011, at the Eye Clinic of Pleven University Hospital. The average age of patients was 67 years (range 29-84 years). Additional risk factors were registered in 22.67% of the patients. Early postoperative complications occurred in 56.79%. In the early postoperative period, 81.31% of the patients had clear graft and improvement of visual acuity was achieved in 83.77%. In the late postoperative period, the graft failed in 28.95% of the patients. These results suggest that bullous keratopathy is an important complication after cataract surgery, and improvement of vision is possible only with keratoplasty.

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