scholarly journals Long-Term Anatomical and Functional Survival of Boston Type 1 Keratoprosthesis in Congenital Aniridia

2021 ◽  
Vol 8 ◽  
Author(s):  
Ariann Dyer ◽  
Alix De Faria ◽  
Gemma Julio ◽  
Juan Álvarez de Toledo ◽  
Rafael I. Barraquer ◽  
...  
Keyword(s):  
Retention Rate ◽  
Functional Results ◽  
Long Term Results ◽  
Cumulative Probability ◽  
Congenital Aniridia ◽  
Boston Type 1 Keratoprosthesis ◽  
The Mean ◽  
Retroprosthetic Membrane

Purpose: To analyze the long-term anatomical survival, functional survival, and complications of Boston type 1 keratoprosthesis (KPro) in the eyes with congenital aniridia-associated keratopathy (AAK).Methods: A retrospective review of 12 eyes with congenital aniridia that underwent a Boston type 1 KPro surgery was conducted. A Kaplan–Meier analysis was performed. Anatomical and functional success criteria were KPro retention and a best corrected visual acuity (BCVA) ≤1.3 LogMAR (≥0.05 decimal) at the end of a follow-up period. Postoperative complications were recorded.Results: The mean preoperative BCVA was 2.1 ± 0.9 (range: 3.8–1) LogMAR, and glaucoma was a comorbidity in all the cases. Five years after the surgery, the overall retention rate was 10/12 (83.3%), and 50% had functional success. Only three (25%) of the 12 cases did not achieve a BCVA ≤1.3 LogMAR. The cumulative probability of anatomical success was 92, 79, and 79% after 1, 5, and 10 years, respectively. The cumulative probability of functional success was 57 and 46% after 1 and 5 years, respectively. The mean anatomical and functional survival time was 10 ± 1.3 (95% IC = 7.5–12.3 years) and 3.8 ± 0.9 years (95% IC = 1.8–5.8 years), respectively. The most common postoperative complication was retroprosthetic membrane (RPM) formation in 8/16 cases (66%). The mean number of complications per case was 2.4 ± 1.8 (0–6).Conclusions: The Boston type 1 KPro is a viable option for patients with AAK with good anatomical and functional long-term results. Glaucoma is an important preoperative condition that affects functional results. Retroprosthetic membrane formation seems to have a higher incidence in this condition.

Time to achieve best postoperative visual acuity following Boston keratoprosthesis surgery

2021 ◽  
pp. bjophthalmol-2020-317483
Author(s):  
Jonathan El-Khoury ◽  
Majd Mustafa ◽  
Roy Daoud ◽  
Mona Harissi-Dagher
Keyword(s):  
Visual Acuity ◽  
Contributing Factors ◽  
Time Duration ◽  
Patient Demographics ◽  
Snellen Visual Acuity ◽  
Boston Type 1 Keratoprosthesis ◽  
The Mean ◽  
Retroprosthetic Membrane

Background/aimsTo evaluate the time needed for patients with Boston type 1 keratoprosthesis (KPro) to reach their best-corrected visual acuity (BCVA) and all contributing factors.MethodsWe retrospectively reviewed 137 consecutive eyes from 118 patients, measured how long they needed to reach their BCVA and looked at factors that might affect this time duration including patient demographics, ocular comorbidities and postoperative complications.ResultsThe mean follow-up was 5.49 years. The median time to BCVA postoperatively was 6 months, with 47% of patients achieving their BCVA by 3 months. The mean best achieved logMAR visual acuity was 0.71, representing a gain of 6 lines on the Snellen visual acuity chart. Postoperative glaucoma, retroprosthetic membrane (RPM) and endophthalmitis prolonged this duration. We found no correlation between the following factors and time to BCVA: gender, age, indication for KPro surgery, primary versus secondary KPro, number of previous penetrating keratoplasties, previous retinal surgery, intraoperative anterior vitrectomy and preoperative glaucoma.ConclusionIn our retrospective cohort, the majority of subjects reached their BCVA between 3 and 6 months after KPro implantation. This duration was significantly prolonged by the development of postoperative glaucoma, RPM and endophthalmitis.

Long-Term Results After Policization for Congenital Hand Deformities

Hand Surgery ◽  
1997 ◽  
Vol 02 (02) ◽  
pp. 79-85 ◽  
Author(s):  
Toshihiko Ogino ◽  
Seiichi Ishii
Keyword(s):  
Functional Results ◽  
Long Term Results ◽  
Pinch Strength ◽  
Cosmetic Results ◽  
Opposite Hand ◽  
Hand Deformities ◽  
The Mean ◽  
Congenital Hand Deformities

Thirteen patients — 18 hands — have been treated with pollicization and could be followed-up for 2 years to 19 years with an average of 7.9 years. Surgery was performed according to the Buck-Gramcko method. The mean age at the time of pollicization was 1.7 years. The parents were satisfied with the cosmetic results in all cases, and they were satisfied with the functional results in all except 4 hands. At follow-up, all patients could use the pollicized digit for pinch. Excellent pinch function has been achieved in 11 hands, good in 2, and fair in 1. The average percent pinch strength compared to the opposite hand was 55%. Association of a radial club hand and contracture of the pollicized digit and other fingers seemed to influence the postoperative pinch function.

Long-term Results of Isolated Anterolateral Bundle Reconstructions of the Posterior Cruciate Ligament

2009 ◽  
Vol 37 (8) ◽  
pp. 1499-1507 ◽  
Author(s):  
Stijn Hermans ◽  
Kristoff Corten ◽  
Johan Bellemans
Keyword(s):  
Cruciate Ligament ◽  
Functional Results ◽  
Long Term Results ◽  
Time Of Surgery ◽  
Anterolateral Bundle ◽  
Graft Choice ◽  
Arthroscopically Assisted ◽  
The Mean

Background Little is known about the parameters that influence the long-term results of isolated arthroscopically assisted reconstructions of the anterolateral bundle of the posterior cruciate ligament (PCL). Hypothesis Chondrosis, time interval from injury to surgery, and graft choice significantly influence the long-term results of single-bundle PCL reconstructions. Study Design Case series; Level of evidence, 4. Methods Between 1995 and 2001, 22 male and 3 female patients with a mean age of 30.8 years (range, 17-52) underwent an anterolateral bundle reconstruction of the PCL for functional instability and pain. Nine were treated with a bone–patellar tendon– bone autograft (BPTB), 15 with a semitendinosus gracilis (STG) autograft, and 1 with an Achilles tendon allograft. Twenty-two patients were clinically and radiographically reviewed at a mean follow-up of 9.1 years (range, 6.5-12.6). Three patients were interviewed by telephone. Thirteen patients had chondrosis at time of surgery. The mean time from injury to surgery was 1.5 years. Results The mean final International Knee Documentation Committee (IKDC), Lysholm, and functional visual analog scale (VAS) scores (65, 75, and 8, respectively) were fair to good and were significantly better than preoperatively (38, 50, and 4, respectively) (P <. 001). The final Tegner (5.7) score was significantly lower than the preinjury score (7.2) (P <. 001). The mean anteroposterior laxity measured by KT-1000 arthrometer and Telos stress radiographs was significantly increased on the operated side (mean side-to-side difference of 2.1 mm and 4.7 mm, respectively). The functional scores were not significantly different between the BPTB and STG reconstructions. Patients without chondrosis at time of surgery and patients operated within the first year from injury had significantly better functional results at final follow-up (P <. 05). Conclusion Arthroscopically assisted reconstructions of the anterolateral bundle of the PCL in patients with symptomatic isolated grade II to IV PCL-deficient knees lead to significantly improved functional results at long term if there is no cartilage damage at time of surgery. Nonoperative treatment should not be extended more than 1 year from injury. Graft choice did not significantly influence the functional outcome at long term.

scholarly journals Adaptive Proximal Scaphoid Implant: Indications and Long-Term Results

2019 ◽  
Vol 08 (04) ◽  
pp. 344-350 ◽  
Author(s):  
Marie-Anne Poumellec ◽  
Olivier Camuzard ◽  
Jean-Pierre Pequignot ◽  
Nicolas Dreant
Keyword(s):  
Grip Strength ◽  
Functional Results ◽  
Contralateral Side ◽  
Long Term Results ◽  
Carpal Collapse ◽  
Flexion Extension ◽  
The Mean ◽  
Carpal Height

Objective This study aims to define the indications of APSI and to evaluate the long-term results. Patients and Methods This is a monocentric study including patients that underwent an arthroplasty of the scaphoid proximal pole using an APSI between 1994 and 2010. Patients were assessed using autoquestionnaires and measuring ranges of motion, key pinch, and grip strength. X-ray views of the wrist were done to control the mobility of the implant and the evolution of the carpal collapse, if present. Results There were 19 patients included with a mean follow-up of 11 years. The mean range of motion was 106 degrees (65% of contralateral side) in flexion-extension and 33 degrees (78% of contralateral side) in radialulnar deviation. The mean grip strength was 72% of the contralateral side. The mean Mayo wrist score was 69/100, the mean QuickDASH 26/100, and the mean patient-rated wrist evaluation (PRWE) 25/100. After 10 years, evolution to osteoarthritis was noted in 32% of the patients. This was associated with a decrease of the carpal height. More specifically, capito-lunate osteoarthritis was noted after 10 years and two out of three patients were concerned after 20 years of follow-up. No osteoarthritis was diagnosed at the radiolunate articulation. Conclusion APSI is a treatment option that enables patients with scaphoid nonunion advanced collapse (SNAC), scapholunate advanced collapse (SLAC) I or II to preserve the strength and mobility with good functional results. But this arthroplasty does not prevent natural evolution to a carpal collapse after a follow-up of 20 years which is clinically well tolerated.

scholarly journals Long-Term Clinical Results of Trabectome Surgery

2021 ◽  
Author(s):  
Yasemin Un ◽  
Cihan Buyukavsar ◽  
Dogukan Comerter ◽  
Murat Sonmez
Keyword(s):  
Risk Factors ◽  
Glaucoma Surgery ◽  
Long Term Results ◽  
Cumulative Probability ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Trabectome Surgery ◽  
The Mean

Abstract Purpose: To analyze the long-term results of trabectome surgery and to characterize risk factors for failure.Method: This is a single-center retrospective study including 66 eyes of 56 patients who underwent trabectome alone (TA) or phacotrabectome (TP) surgeries between 2012-2016. Surgical success was defined as intraocular pressure (IOP) drop by 20% or IOP ≤21 mmHg and no further glaucoma surgery. Risk factors for further surgeries were analyzed with Cox proportional hazard ratio models. Cumulative success analysis of subgroups was completed with the Kaplan Meier analysis.Results: Mean follow-up period was 59.7±14.1 months. During the follow-up period, 15 of 62 (24.2%) eyes had additional glaucoma surgery. The mean preoperative IOP was 26.8±6.5 mmHg. The mean last visit IOP was 18.7±4.5 mmHg (p<0.01). IOP decreased 30.1% from baseline at the last visit. Average numbers of medications used were 3.42 ±0.76 (range 1-4) and 2.45±1.33 (range 0-4) at preoperative and last visit, respectively (p<0.01). The risk factors for further surgery requirements were higher baseline IOP (HR:1.12, p:0.01), higher central corneal thickness (CCT) (HR:1.01, p:0.04), and higher amounts of preoperative drugs (HR:2.22, p:0.08). The cumulative probability of success was 93.5%, 90.5%, 85.5%, 80.6%, and 77.4% at 3, 12, 24, 36, and 60 months, respectively. Kaplan Meier survival plots indicating the time of additional glaucoma surgery in the subgroups showed higher survival probability in primary open angle glaucoma (POAG), males, phacotrabectome cases, early stage glaucoma, and eyes without previous glaucoma surgery. Conclusion: Trabectome success ratio was 50% at 59 months. Higher baseline IOP and thicker CCT are associated with an increased risk of further glaucoma surgery.

Long-term results of scapulothoracic arthrodesis with multiple cable method for facioscapulohumeral dystrophy

2018 ◽  
Vol 100-B (7) ◽  
pp. 953-956 ◽  
Author(s):  
A. Erşen ◽  
A. C. Atalar ◽  
S. Bayram ◽  
M. Demirel ◽  
O. Tunalı ◽  
...  
Keyword(s):  
Functional Results ◽  
Long Term Results ◽  
First Year ◽  
Range Of Movement ◽  
Facioscapulohumeral Dystrophy ◽  
Early Improvement ◽  
Shoulder Flexion ◽  
The Mean

AimsThe present study aimed to investigate the long-term functional results of scapulothoracic fusion using multifilament cables in patients with facioscapulohumeral dystrophy (FSHD) to identify if the early improvement from this intervention is maintained.Patients and MethodsWe retrospectively investigated the long-term outcomes of 13 patients with FSHD (18 shoulders) in whom scapulothoracic fusion using multifilament cables was performed between 2004 and 2007. These patients have previously been reported at a mean of 35.5 months (24 to 87). There were eight men and five women with a mean age of 26 years. Their mean length of follow-up of our current study was 128 months (94 to 185). To evaluate long-term functional results, the range of shoulder flexion and abduction, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores were analyzed with a comparison of preoperatively, interim and at the final outcomes. The fusion was examined radiographically in all.ResultsThe complication rate was 33% (six of 18 scapulothoracic fusions) in 13 patients, which comprised failure of fusion in four shoulders (four patients) all occurring within the first year postoperatively. In two shoulders (one patient) wound problems arose due to attribution from the cables which required shortening but the fusion developed satisfactorily. At the final examination, the mean QuickDASH score and range of movement significantly improved in all but one patient (p < 0.001, p < 0.001 and p < 0.001). In the comparison of 13 patients’ mid- and long-term results, the mean QuickDASH score decreased from 9.8 (sd 6.7; 3 to 26) in the third year to 9.1 (sd 5.6; 3 to 22) in the tenth year (p = 0.7); the mean range of shoulder flexion and abduction decreased from 129° (sd 22°; 90° to 160°) and 124° (sd 12; 100° to 150°) at the mid-term to 103° (sd 12°; 80° to 120°) and 101° (sd 8°; 80° to 120°) at the long-term, respectively (p = 0.78 and p = 0.65).ConclusionScapulothoracic fusion using a multiple cabling method can confer a considerable improvement in clinical and functional outcomes for most patients with FSHD after a long follow-up period. The technique requires careful execution to avoid complications. Cite this article: Bone Joint J 2018;100-B:953–6.

Comparative Study of effectiveness of mobilization with movement (MWM) and End range mobilization (ERM) techniques in frozen shoulder

2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Type I ◽  
Mean Values ◽  
Functional Activities ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.

Clinical Experience with a New Nitinol Self-Expanding Stent in Peripheral Arteries

1996 ◽  
Vol 3 (4) ◽  
pp. 369-379 ◽  
Author(s):  
Michel Henry ◽  
Max Amor ◽  
Rafael Beyar ◽  
Isabelle Henry ◽  
Jean-Marc Porte ◽  
...  
Keyword(s):  
Long Term Results ◽  
Lesion Length ◽  
Secondary Patency ◽  
Peripheral Arteries ◽  
External Compression ◽  
Nitinol Stent ◽  
Nitinol Stents ◽  
The Mean

Purpose: To evaluate a new self-expanding nitinol coil stent in stenotic or occluded peripheral arteries. Methods: Seventy-three symptomatic patients (58 men; mean age 67 years) were treated with nitinol stents for lesions in the iliac artery (9 stenoses); superficial femoral artery (SFA) (39 stenoses, 6 occlusions); popliteal artery and tibioperoneal trunk (9 stenoses, 7 occlusions); and 3 bypass grafts. Mean diameter stenosis was 84.4% ± 9.9% (range 75% to 100%), and mean lesion length was 45 ± 23 mm (range 20 to 120 mm). Results: Eighty-eight 40-mm-long stents with diameters between 5 and 8 mm were implanted percutaneously for suboptimal dilation (n = 45); dissection (n = 21); and restenosis (n = 7). All stents but one were implanted successfully; the malpositioned stent was removed, and another stent was successfully deployed. There were 3 (4.1%) failures due to thrombosis at 24 hours. During the mean 16-month follow-up (range to 44 months), 4 restenoses (3 femoral, 1 popliteal) have occurred; 2 were treated with repeat dilation and 2 underwent bypass. Primary and secondary patency rates at 18 months were 87% and 90%, respectively, for all lesions (iliac: 100% for both; femoral: 85% and 88%; popliteal: 87% and 100%). Conclusions: This new nitinol stent seems to be safe and effective with favorable long-term results, even in distal SFA lesions and popliteal arteries. Its flexibility and resistance to external compression allow its placement in tortuous arteries and near joints.

scholarly journals Short stump and high anastomosis pull-through (SHiP) procedure for delayed coloanal anastomosis with no protective stoma for low rectal cancer

2021 ◽  
Vol 73 (2) ◽  
pp. 495-502
Author(s):  
Francesco Bianco ◽  
Paola Incollingo ◽  
Armando Falato ◽  
Silvia De Franciscis ◽  
Andrea Belli ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Coloanal Anastomosis ◽  
Functional Results ◽  
Anal Margin ◽  
Perioperative Mortality ◽  
The Mean ◽  
Pull Through ◽  
Protective Stoma

AbstractDespite advances in coloanal anastomosis techniques, satisfactory procedures completed without complications remain lacking. We investigated the effectiveness of our recently developed ‘Short stump and High anastomosis Pull-through’ (SHiP) procedure for delayed coloanal anastomosis without a stoma. In this retrospective study, we analysed functional outcomes, morbidity, and mortality rates and local recurrence of 37 patients treated using SHiP procedure, out of the 282 patients affected by rectal cancer treated in our institution between 2012 and 2020. The inclusion criterion was that the rectal cancer be located within 4 cm from the anal margin. One patient died of local and pulmonary recurrence after 6 years, one developed lung and liver metastases after 2 years, and one experienced local recurrence 2.5 years after surgery. No major leak, retraction, or ischaemia of the colonic stump occurred; the perioperative mortality rate was zero. Five patients (13.51%) had early complications. Stenosis of the anastomosis, which occurred in nine patients (24.3%), was the only long-term complication; only three (8.1%) were symptomatic and were treated with endoscopic dilation. The mean Wexner scores at 24 and 36 months were 8.3 and 8.1 points, respectively. At the 36-month check-up, six patients (24%) had major LARS, ten (40%) had minor LARS, and nine (36%) had no LARS. The functional results in terms of LARS were similar to those previously reported after immediate coloanal anastomosis with protective stoma. The SHiP procedure resulted in a drastic reduction in major complications, and none of the patients had a stoma.

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