scholarly journals Penetrating Keratoplasty with a Preserved Donor Cornea in Veterinary Ophthalmology

2019 ◽  
Vol 9 (1) ◽  
pp. 71
Author(s):  
Boris. V. Usha ◽  
Svetlana Y. Kontsevaya ◽  
Vladimir I. Lutsay ◽  
Inga. M. Nityaga ◽  
Uliyana E. Lukashina
Keyword(s):  
Penetrating Keratoplasty ◽  
High Rate ◽  
Medical Emergency ◽  
Donor Cornea ◽  
Complete Excision ◽  
Corneal Ulcers ◽  
Optical Functions ◽  
Corneal Transplants ◽  
Suture Failure ◽  
Late Postoperative Period

The present article describes the penetrating keratoplasty using the technique of rehydration of donor cornea dehydrated over silica gel, as well as complications that can arise. The indications included corneal ulcers, descemetocoele, corneal sequestrum and corneal perforation. 37 (88.37%) out of 43 corneal transplants had a favorable outcome in surgeries with complete excision of abnormal tissues. In 5 cases (11.63%), the authors faced such complications as suture failure, formation of anterior synechias, incomplete epithelization after the suture removal, and transplant swelling reversed with the preservation of eye optical functions, and secondary glaucoma in the late postoperative period that ended up in eyeball endoprosthesis transplantation. Due to a high rate of efficiency of the proposed method, penetrating keratoplasty with rehydrated grafts can be recommended for the treatment in case of medical emergency experienced by cats and dogs.

Corneal Sensitivity after Penetrating Keratoplasty

1993 ◽  
Vol 3 (2) ◽  
pp. 66-70 ◽  
Author(s):  
I. Tuğal Tutkun ◽  
K. Akarçay ◽  
L. Közer Bilgin ◽  
N. Sansoy ◽  
M. Urgancioğlu
Keyword(s):  
Correlation Analysis ◽  
Postoperative Period ◽  
Preoperative Diagnosis ◽  
Penetrating Keratoplasty ◽  
Test Results ◽  
Clinical Testing ◽  
Corneal Sensitivity ◽  
Graft Size ◽  
Progressive Improvement ◽  
Corneal Transplants

In order to determine corneal sensitivity after penetrating keratoplasty, 71 corneal transplants and their recipient beds were tested using the Cochet-Bonnet esthesiometer. The periods from surgery to examination were two weeks to 15 years. When the test results were divided into six groups according to the postoperative period, correlation analysis revealed a progressive improvement of sensitivity in the central and peripheral graft as well as in the recipient cornea. Only one graft had normal central sensitivity at 24 months; 36 grafts were completely anesthetic while 35 grafts had some level of sensitivity at the time of last clinical testing. Age, preoperative diagnosis or graft size were not correlated with the recovery of sensitivity. The extent and time of reinnervation in corneal grafts varied in individual patients.

scholarly journals 221 Delirium Detection in the ED Utilizing the 4AT Delirium Screening Tool

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Louise Kelly ◽  
Caitriona Whelan ◽  
Maeve Ryan ◽  
Ruth Wade ◽  
Orla Boyle ◽  
...  
Keyword(s):  
At Risk ◽  
Assessment Tool ◽  
Clinical Care ◽  
Routine Screening ◽  
High Rate ◽  
Medical Emergency ◽  
Tertiary Referral Centre ◽  
Clinical Frailty Scale ◽  
Acute Setting ◽  
Increased Risk

Abstract Background Delirium is a medical emergency and is associated with increased risk of mortality, in-hospital complications, length of stay and institutionalisation. Delirium screening is recommended for patients at risk on admission. Despite this, delirium screening is frequently not undertaken in the acute setting leading to undiagnosed delirium and sub-optimal clinical care. We aim to investigate the prevalence of delirium in patients aged ≥75 years attending the Emergency Department (ED) of a tertiary referral centre. Methods Patients aged ≥75yrs presenting to the ED between 08.30 and 18.30, Monday- Friday were assessed by an interdisplinary gerontological service using a standardised assessment tool including the 4AT to screen for delirium. Data was collected and analysed via Excel. Results Of 163 patients screened over a 4 week period 47.9% (78/163) were male with a mean age of 81.8 years (SD 2.7). Twenty three percent (34/148) scored ≥4 indicating a possible delirium. Patients with delirium were older (85 yrs vs. 80 yrs, P<0.001), were more likely to score ≥4 on Clinical Frailty Scale (97% vs. 56%, P<0.001), and at risk of, or have malnutrition (MNA SF score <12) (86% vs. 40%, P<0.001). Conclusion Routine screening of patients in the acute setting detected a high rate of delirium at a level which is consistent with previous studies. Patients with delirium were older, more frequently frail and at risk of malnutrition. Our results support the evidence for routine screening for delirium in the acute setting.

scholarly journals Individualized penetrating keratoplasty using edge-trimmed glycerol-preserved donor corneas for perforated corneal ulcers

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Guozhen Niu ◽  
Qi Zhou ◽  
Xinyu Huang ◽  
Sangsang Wang ◽  
Juan Zhang ◽  
...  
Keyword(s):  
Penetrating Keratoplasty ◽  
Corneal Ulcers ◽  
Donor Corneas

Selective Positioning of the Donor Cornea in Penetrating Keratoplasty for Keratoconus

Cornea ◽  
1984 ◽  
Vol 3 (2) ◽  
pp. 135???140 ◽  
Author(s):  
Richard C. Troutman ◽  
Casimir A. Swinger ◽  
Sandra Belmont
Keyword(s):  
Penetrating Keratoplasty ◽  
Donor Cornea

scholarly journals ATRA Availability on Formulary for the Treatment of APL Across Hospitals in the State of Georgia

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4924-4924 ◽  
Author(s):  
Sarah Wheeler ◽  
Harika Puttagunta ◽  
Minal Surati ◽  
Elyse Panjic ◽  
Arpita Shah ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Research Funding ◽  
Blood Bank ◽  
Early Mortality ◽  
The State ◽  
High Rate ◽  
Medical Emergency ◽  
Pharmacy Staff ◽  
Transfusion Requirements ◽  
Society Research

Abstract Introduction: Newly diagnosed acute promyelocytic leukemia (APL) represents a medical emergency that's associated with a high rate of early mortality primarily due to bleeding from disseminated intravascular coagulation (DIC). Initiation of all-trans retinoic acid (ATRA) leads to rapid resolution of DIC. As such, it is recommended that ATRA be started at the first suspicion of APL even if the diagnosis is not confirmed. Patients should also receive supportive care with platelets, cryoprecipitate, and fresh frozen plasma as indicated until resolution of coagulopathy. Early mortality in APL continues to be a challenge that hinders outcomes when patients are managed at community and academic leukemia centers as compared to those managed on clinical trials. It has been suggested that the unavailability of ATRA on formulary in some leukemia treating centers might be one of the reasons contributing to the high induction mortality in APL. We designed this study to identify the availability of ATRA in hospitals in the state of Georgia. In addition information was obtained on the availability of blood bank support across the state. Methods: The Medicare hospital database was utilized (accessed online from data.medicare.gov) to identify all hospitals within the state of Georgia registered with Medicare. A total of 135 hospitals were identified. One hospital was excluded since it recently closed. The remaining 134 hospitals were contacted by telephone and a brief survey of seven questions was conducted (Table 1) with a member of the hospital pharmacy staff, and if needed additional hospital staff including physicians practicing at that site were contacted. Results: Of the 134 evaluable hospitals, 114 hospitals did not treat patients with leukemia. Patients with a suspected diagnosis of leukemia (including APL) are expeditiously transferred to a larger center. A total of 18 (13%) hospitals had ATRA in stock at the time of the survey including one center which does not routinely treat patients with leukemia. 20/134 hospitals treat leukemia patients including three hospitals that treat selected diagnoses only and usually transfer APL patients to a larger center. 17/20 (85%) of the leukemia treating hospitals maintain ATRA on formulary. The three hospitals that do not have ATRA on formulary have operating procedures in place to procure it within a day. The same three hospitals are also the ones that tend to transfer APL patients to a larger center. 103/134 (80%) hospitals in the state had blood bank support and three additional hospitals had arrangements to obtain blood from a nearby blood bank. The 20 hospitals that regularly treat leukemia had full service blood banks that had the capability of meeting the transfusion requirements of APL. Conclusion: Most hospitals in the state of Georgia do not routinely treat acute leukemia patients. Only 1/114one of the 114 centers that do not treat leukemia patients had ATRA on formulary. ATRA and blood bank support are readily available in majority of the centers that treat leukemia patients in the state of Georgia and lack of ATRA availability is unlikely to be a contributing factor to early deaths in these centers. Table 1. Telephone Survey Is ATRA on the hospital's formulary? If no to question 1, could ATRA be ordered if needed and if so, how quickly would it be delivered? Is ATRA currently in stock? Is there a hematologist on staff? Are acute leukemia patients treated at the hospital? Is there a blood bank on site? Disclosures Jillella: Leukemia Lymphoma Society: Research Funding. Kota:Leukemia Lymphoma Society: Research Funding; Pfizer: Membership on an entity's Board of Directors or advisory committees.

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.

scholarly journals Penetrating Keratoplasty for Keratoconus in Vietnamese Patients

2019 ◽  
Vol 7 (24) ◽  
pp. 4287-4291
Author(s):  
Le Xuan Cung ◽  
Duong Mai Nga ◽  
Nguyen Dinh Ngan ◽  
Nguyen Xuan Hiep ◽  
Do Quyet ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Contact Lenses ◽  
High Rate ◽  
Posterior Subcapsular Cataract ◽  
Corrected Visual Acuity ◽  
Severe Stage ◽  
Hard Contact ◽  
Best Corrected Visual Acuity ◽  
Corneal Disorder

BACKGROUND: Keratoconus is an ectatic corneal disorder that can impair the visual acuity. Up to now, penetrating keratoplasty (PK) remains the most common surgical procedure to treat severe keratoconus. In Vietnam, most keratoconus patients come to visit doctor at severe stage and were treated by PK, so we conduct this study. AIM: To evaluate the results of PK for keratoconus in Vietnamese patients. METHODS: This was a retrospective study of 31 eyes with keratoconus who underwent PK in VNIO from January 2005 to December 2014. RESULTS: The average visual acuity was 0.86 ± 0.37 logMAR (20/145). In the group of patients without amblyopia, best spectacle-corrected visual acuity of 20/60 or better was recorded in 75.9% of eyes and 93.1% of eyes achieved a best corrected visual acuity with hard contact lenses of 20/40 or better. Mean postoperative corneal power was 43.8 ± 4.5D. Mean corneal astigmatism was 5.9 ± 2.7D. 94.6% of grafts remained clear. Posterior subcapsular cataract developed in 22.6% of eyes. Graft rejection was recognized in 12.9% of eyes. CONCLUSION: PK is an effective procedure with high rate of graft survival for keratoconus patients. However, patients should be aware of the necessary of optical correction to gain the best VA after surgery.

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