Indications for and outcomes of repeat penetrating keratoplasty, 1989–1995

Patel, N. K.; Kim, Terry; Rapuano, Christopher J.; Cohen, Elisabeth J.; Laibson, Peter R.

doi:10.1016/s0161-6420(00)00003-8

Cited by 117 publications

(90 citation statements)

References 12 publications

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“…Age-related and post-operative changes, such as increasing pleomorphism, polymegethism, decreasing cell density in corneal endothelial layer and increasing corneal thickness, have already been observed and well described in several studies [5,7,[21][22][23][24][25][26]. Bourne [27] reported that the markedly enlarged endothelial cells in long-term corneal transplants have a reduced ability to keep cornea clear.…”

Section: Financial Interestmentioning

confidence: 79%

“…At examination time, recipient patients' mean age was 42. thy, Fuch's dystrophy, keratoconus, corneal scarring and aphakic bullous keratopathy [3,5,7] are considered to be main indications for PKP. Different studies on PKP have reported that the 1-year survival rate of donor cornea is up to 90 %, at 5 years it is 88 %, at 10 years it is 80 % and in the 2007 Australian graft report it is 60 % [10][11][12].…”

Section: Resultsmentioning

confidence: 99%

“…In our study, the morphology of the donors' central corneal endothelial cell has been traced for an average of 5.4 years after PKP to assess the longevity of the transplanted grafts. Relatively few reports have been made to study at least 5-year-graft survival including detailed donor endothelial data as is present in our study [2][3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of endothelial cell density and corneal thickness in corneal grafts an average of 5 years after penetrating keratoplasty

Kettesy

Németh

Kemény-Beke

et al. 2014

Wien Klin Wochenschr

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SummaryBackground Corneal transparency is a useful indicator for corneal function. Our aim was to investigate central corneal endothelial cells and corneal thickness in transplanted corneas at an average of 5.4 years after penetrating keratoplastyPatients and methods The study involved 68 perforated keratoplasty patients with at least a 1 year followup. Post-operatively, the central corneal endothelial layer was observed using a contact specular microscope. Central endothelial cell density, corneal thickness and the coefficient of variation of endothelial size were statistically analysed.Results The post-operative follow-up time was ranging from 12 months to 23 years. Endothelial cell density (ECD) was 1,501 ± 249 cell/mm 2 . The average cell size was 673.6 ± 98.3 μm 2 , and the coefficient of variation of cell size was 0.61 ± 0.11. No difference in ECD was detected between diagnostic groups. Corneal thickness was 0.56 ± 0.06 mm. Correlation between ECD and post-operative time was not significant (r = 0.02; p = 0.85).Conclusion Our study concluded that ECD showed a higher rate of decrease after penetrating keratoplasty with no relation to pre-operative diagnosis.Keywords Endothelial cell loss · graft survival · penetrating keratoplasty · specular microscope Bestimmung der Endothelzelldichte und der Hornhautdicke in Hornhauttransplantaten circa 5 Jahre nach einer penetrierenden Keratoplastik Zusammenfassung Hintergrund Die Transparenz der Cornea ist ein nütz-licher Indikator der Funktion der Hornhaut. Das Ziel unserer Studie war es, die zentralen Endothelzellen der Cornea sowie die Dicke der Hornhaut in transplantierten Hornhäuten circa 5,4 (im Durchschnitt) Jahre nach penetrierender Keratoplastik zu untersuchen.Patienten und Methoden In die Studie wurden 68 Patienten nach perforierter Keratoplastik aufgenommen, die zumindest 1 Jahr nachuntersucht worden waren. Postoperativ wurde die zentrale Endothelschicht der Hornhautmittel seines Kontakt-Spekular Mikroskops untersucht. Die Dichte der zentralen Endothelzellen, die Dicke der Hornhaut und der Variations-Koeffizient der Größe des Endothels wurden statistisch analysiert.Ergebnisse Der Zeitpunkt der postoperativen Kontrollen variierte von 12 Monaten bis 23 Jahren. Die Endothelzelldichte (EZD) lag bei 1501 ± 249 Zelle/mm 2 . Der Mittelwert der Zellgröße war 673,6 ± 98,3 μm 2 und der Variationskoeffizient 0,61 ± 0,11. Es gab keinen Unterschied in der EZD zwischen den nach Diagnosen eingeteilten Gruppen. Die Korrelation zwischen der EZD und dem Zeitabstand zur Operation war nicht kant (r = 0,02; p = 0,85).Schlussfolgerung Unsere Studie zeigt unabhängig von der präoperativen Diagnose eine abfallende Tendenz der EZD nach penetrierender Keratoplastik.

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Section: Financial Interestmentioning

confidence: 79%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessment of endothelial cell density and corneal thickness in corneal grafts an average of 5 years after penetrating keratoplasty

Kettesy

Németh

Kemény-Beke

et al. 2014

Wien Klin Wochenschr

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“…41,45,46 While the most common indication for initial PKP in cases with repeat keratoplasty was bullous keratopathy in developed nations, active keratitis and corneal scar were indications in developing nations. Even in the paediatric age group the indications for keratoplasty differ in developing and developed nations (Table 6).…”

Section: Causes Of Corneal Blindnessmentioning

confidence: 99%

The value of corneal transplantation in reducing blindness

Garg

Krishna

Stratis

et al. 2005

Eye

125

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Purpose To analyse the role of keratoplasty in reducing world blindness due to corneal diseases. Methods Review of published literature. We collected and analysed articles published in the English language literature related to the prevalence and causes of blindness in different parts of the world, causes of corneal blindness, and outcome of corneal transplantation for various corneal diseases. Results A total of 80% of the world's blind live in developing countries. Retinal diseases are the most important causes of blindness (40-54%) in established economy nations while cataract (44-60%) and corneal diseases (8-25%) are the most common causes of blindness in countries with less developed economies. Keratitis during childhood, trauma, and keratitis during adulthood resulting in a vascularized corneal scar and adherent leucoma are the most frequent causes of corneal blindness in developing countries. Corneal diseases are responsible for 20% of childhood blindness. Nearly 80% of all corneal blindness is avoidable. The outcome of keratoplasty for vascularized corneal scar and adherent leucoma is unsatisfactory, necessitating repeat surgery in a high proportion of these cases. Other barriers for keratoplasty in these nations are suboptimal eye banking, lack of trained human resources, and infrastructure. Conclusions Since the developing world carries most of the load of corneal blindness and the major causes of corneal blindness are corneal scar and active keratitis, development of corneal transplantation services need a comprehensive approach encompassing medical standards in eye banking, training of cornea specialists and eye banking personnel and exposure of ophthalmologists to care of corneal transplants for better follow-up care. However, concerted efforts should be made to develop and implement prevention strategies since most corneal blindness is preventable.

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“…A indicação do transplante de córnea varia de acordo com a epidemiologia e a prática do Serviço onde é realizado o procedimento (1,5) . Em muitos Serviços, o ceratocone é a principal indicação para ceratoplastia penetrante (1,5,10) , embora outros evidenciem a ceratopatia bolhosa como indicação mais freqüente (11) . Na presente amostra, o ceratocone e a ceratopatia bolhosa pós-facectomia foram as principais indicações para ceratoplastia penetrante, observando-se proporções semelhantes entre estes.…”

Section: I S C U S S ã Ounclassified

Ceratoplastias penetrantes realizadas na Fundação Altino Ventura: revisão dos resultados e complicações

Endriss¹,

Cunha²,

Ribeiro³

et al. 2003

Arq. Bras. Oftalmol.

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Objetivo: Identificar as principais complicações e causas de insucesso das ceratoplastias penetrantes realizadas na Fundação Altino Ventura, Recife-PE. Métodos: Revisaram-se os prontuários médicos de 205 pacientes, submetidos a ceratoplastia penetrante na Fundação Altino Ventura, no período de janeiro de 1999 a dezembro de 2000, com tempo de seguimento pós-operatório maior ou igual a seis meses. Avaliaram-se dados demográ-ficos e relacionados aos períodos pré, per e pós-operatório. Resultados: A média de idade dos pacientes foi de 48,4 (± 22,1) anos, sendo 108 (52,7%) do sexo feminino. As principais indicações do transplante penetrante de córnea foram ceratocone (49 casos, 23,9%), ceratopatia bolhosa pós-facectomia (48 casos, 23,4%) e distrofias (24 casos, 11,7%). A complicação pós-operatória mais freqüentemente encontrada foi glaucoma em 65 casos (31,7%). Cinqüenta pacientes (24,4%) apresentaram sinais clínicos de rejeição do botão, havendo evolução para insucesso do transplante em 13 (26,0%) destes casos. Observou-se que 16,0% (n=8) dos pacientes com rejeição foram submetidos a três ou mais procedimentos cirúrgicos, diferença estatisticamente significante em relação ao grupo que não desenvolveu rejeição (3,2%, n=5) (p<0,05). Quarenta e cinco (22,0%) transplantes realizados evoluíram com opacificação total do botão doador. Conclusão: Os fatores de risco para falência do transplante de córnea identificados neste estudo concordam com os da literatura mundial. O glaucoma foi a principal complicação pós-operatória identificada e o principal fator predisponente à rejeição e falência do transplante.Penetrating keratoplasties performed at the Fundação Altino Ventura: review of results and complications R E S U M O I N T R O D U Ç Ã OA ceratoplastia penetrante é o procedimento de maior sucesso entre os transplantes teciduais em humanos e tem sido o mais realizado na atualidade (1)(2)(3) . O sucesso desse procedimento cirúrgico tem sido atribuído ao fato da córnea ser avascular e aos privilégios imunológicos desta estrutura. Avanços na técnica cirúrgica, equipamento, materiais, métodos de preservação da córnea doadora e manejo pós-operatório também têm contribuído para o sucesso dos transplantes de córnea (2,(4)(5) O prognóstico dos transplantes de córnea é de natureza multifatorial (6) . Apesar dos progressos evidentes, a evolução pós-operatória da ceratoplastia penetrante depende de fatores prognósticos relacionados ao quadro clínico da doença ocular que motiva a indicação cirúrgica. O reconhecimento

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Indications for and outcomes of repeat penetrating keratoplasty, 1989–1995

Cited by 117 publications

References 12 publications

Assessment of endothelial cell density and corneal thickness in corneal grafts an average of 5 years after penetrating keratoplasty

Assessment of endothelial cell density and corneal thickness in corneal grafts an average of 5 years after penetrating keratoplasty

The value of corneal transplantation in reducing blindness

Ceratoplastias penetrantes realizadas na Fundação Altino Ventura: revisão dos resultados e complicações

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