National Survey on Bullous Keratopathy in Japan

Shimazaki, Jun; Amano, Shiro; Uno, Toshihiko; Maeda, Naoyuki; Yokoi, Norihiko

doi:10.1097/ico.0b013e31802c9e19

Cited by 110 publications

(73 citation statements)

References 42 publications

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“…In Japan, glaucoma surgery (including trabeculectomy) was the third most common cause of bullous keratopathy (5.3%) following cataract surgery (44.4%) and laser iridotomy (23.4%). 1 In eyes with bullous keratopathy having previously undergone trabeculectomy, the results of corneal transplantation may be affected by pre-existing glaucoma conditions and the presence of filtrating blebs. Alternatively, corneal transplantation may affect the control of intraocular pressure (IOP).…”

Section: Introductionmentioning

confidence: 99%

Penetrating keratoplasty for bullous keratopathy after trabeculectomy

Fukuoka

Honda

Usui

et al. 2008

Eye

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Purpose To evaluate the results of penetrating keratoplasty (PK) in eyes with bullous keratopathy having previously undergone trabeculectomy. Methods We reviewed medical records of patients that had undergone PK for bullous keratopathy having previously undergone trabeculectomy. A total of 34 eyes in 34 patients were included in the study. As a control group, we reviewed the medical records of 26 eyes in 26 patients that had no history of glaucoma and who had undergone PK for bullous keratopathy in the same period at the same institutes. Kaplan-Meier survival analysis was performed to estimate the cumulative probability of successful intraocular pressure (IOP) control, immune reaction-free graft, and graft survival. Results Visual acuity improved by more than two lines in 30-34 eyes (88%). Log-rank tests showed a statistically significant difference in the cumulative probability of successful IOP control between eyes with functioning blebs and eyes with non-functioning blebs (P ¼ 0.0005), but not between the experimental subjects of 34 eyes and the control group (P ¼ 0.198). The log-rank test did not show statistically significant differences in the cumulative probability of immune reactionfree grafts and graft failure between the subjects and the control group and between eyes with functioning blebs and eyes with non-functioning blebs. Conclusion The outcomes for PK in bullous keratopathy are good for patients having previously undergone trabeculectomy. Surgical procedures should be performed before PK in eyes with non-functioning blebs even when IOP is controllable with medication.

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Section: Introductionmentioning

confidence: 99%

Penetrating keratoplasty for bullous keratopathy after trabeculectomy

Fukuoka

Honda

Usui

et al. 2008

Eye

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“…A metilcelulose ® parece não ser tão eficaz em proteger o endotélio quanto os outros viscoelásticos dispersivos (10) . Assim como recente pesquisa com mais de 900 pacientes realizado no Japão (1) , observamos que a ceratopatia bolhosa ocorreu mais comumente pós-facoemulsificação em 74.28% (26 olhos) (1,(9)(10) . A facoemulsificação é atualmente realizada por mais de 90% dos cirurgiões de catarata brasileiros (17) .…”

Section: Discussionunclassified

“…A média de idade dos pacientes de nosso estudo foi de 69 anos (51 -81 anos), havendo importante predominância de mulheres nos casos documentados no setor de córnea e doenças externas do Hospital da Piedade. Outros estudos já demonstraram uma maior prevalência em faixa etária acima de 65 anos, mas diferem de nossa aná-lise, mostrando uma prevalência maior em mulheres apenas discreta (1,10) . Notou-se ainda que, em pacientes com idade igual ou superior a setenta anos, a evolução para ceratopatia bolhosa foi mais rápido.…”

Section: Discussionunclassified

“…P roduzida por descompensação de função do endotélio corneal, que leva a formação de bolhas epiteliais, a ceratopatia bolhosa é condição clínica crônica e irreversível, sendo uma das principais indicações de transplante de córnea em vários países (1)(2)(3)(4) . Os estudos vêm mostrando um importante aumento na incidência desta patologia, provavelmente relacionado ao maior número de procedimentos cirúrgicos.…”

Section: Introductionunclassified

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Perfil do paciente com ceratopatia bolhosa pós-facectomia atendidos em hospital público

Santhiago¹,

Monica²,

Kara-Júnior³

et al. 2009

Rev. bras.oftalmol.

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RESUMOObjetivo: Identificar e analisar criticamente o perfil dos pacientes com ceratopatia bolhosa atendidos em um hospital municipal. Métodos: Foi realizada análise retrospectiva de 35 olhos de 35 pacientes em acompanhamento no setor de córnea e doenças externas do Hospital da Piedade, que apresentavam ceratopatia bolhosa pós-facectomia. Foram excluídos aqueles onde não se conseguiu determinar características pré e per-operatórias fundamentais em nossa pesquisa. Esta seleção de pacientes foi realizada durante o perío-do de janeiro de 2007 a junho de 2007. Resultados: Como principais resultados observouse que a ceratopatia bolhosa ocorreu em 22.86 % (8 olhos) dos casos pós-facectomia extracapsular (FEC) e 74.28 % (26 olhos) pós-facoemulsificação. Em 25.71 % (9 olhos) foi documentado rotura de cápsula posterior (RCP) com perda vítrea. Em 94.29 % (33 olhos) a lente intraocular se localizava na câmara posterior, e dois pacientes estavam afácicos. A acuidade visual de todos os pacientes era pior que 20/200. O tempo médio de evolução entre a facectomia e o diagnostico de ceratopatia bolhosa foi 11,93 meses (1 -44 meses). Conclusão: A análise adequada do endotélio corneano é condição essencial para o sucesso da cirurgia de catarata com transparência corneal, e que a ceratopatia bolhosa parece estar mais associada à facoemulsificação. Esta informação deve ser interpretada com cautela, já que esta relação pode vir do maior numero de facoemulsificações realizadas no Hospital onde foi realizado o estudo e muitas destas por cirurgiões em treinamento.

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“…LI used to be a recommended treatment for affected and contralateral eyes in acute angle-closure glaucoma [7]. Shimazaki et al [8] reported a strikingly large number of LI-related BK in Japan. They supposed that the difference in the rate of LI-related BK between Japan and other Western countries was probably attributable to the difference in the prevalence of angle-closure glaucoma [9].…”

Section: Dear Editormentioning

confidence: 98%

Analysis of causes of bullous keratopathy in East China: a 10-year retrospective study

Wang

et al. 2011

Graefes Arch Clin Exp Ophthalmol

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Dear EditorBullous keratopathy (BK) leads to decreased corneal transparency and ultimate loss of visual acuity [1]. According to the previous literatures, BK was one of the leading reasons for corneal transplantation [2][3][4][5], and Fuchs' dystrophy was most commonly seen in the etiology of BK [1-3]. However, Fuchs' dystrophy wasn't the leading cause of BK in China. So we performed a retrospective study to explore the causes of BK in East China in the past 10 years.Medical records of inpatients diagnosed as BK treated in the Eye & ENT Hospital of Fudan University, one of the key eye centers in East China, between 1999 to 2008 were retrospectively reviewed, including demographic characteristics, cause of BK, preoperative conditions, associated disorders and surgery performed.A total of 249 eyes of 214 patients were reviewed in this study, composed of 85 females (39.7%) and 129 males (60.3%) aged from 13 to 86 years (mean 57.15±17.4 years). The leading cause of BK was intraocular surgery (130/249, 52.2%), among which 72.7% (94/130) of eyes were cataract surgery. The following reasons were glaucoma (50/249, 20.1%), ocular trauma (31/249, 12.4%), graft failure (13/ 249, 5.2%), herpes simplex keratitis (13/249, 5.2%), Fuchs' dystrophy (8/249, 3.2%) and laser iridotomy (LI) (4/249, 1.6%). Details of etiology are described in Table 1.As for the interval study, the percentage of BK caused by cataract surgery decreased gradually. In contrast, that induced by ocular trauma increased significantly, and the incidence of glaucoma-related BK was relatively steady in the past 10 years, shown in Fig. 1.Intraocular surgery was the leading cause of BK in East China, accounting for one half of the total cases. With the popularization of cataract surgery in China in the decade, the incidence of pseudophakic and aphakic bullous keratopathy increased dramatically. Interestingly, the percentage of BK due to cataract surgery showed an obvious decreasing trend in the recent 5 years, which may probably be attributed to better surgical techniques, improved intraocular lenses, and proper use of viscoelastics. Our result is similar to other researches [1,2,6].Another finding of this study was that glaucoma caused 20.1% of BK in total cases. Further analysis showed that only six eyes with primary glaucoma developed BK, whereas 44 eyes were caused by secondary glaucoma, suggesting that the risk to develop BK increased dramatically once glaucoma coexisted with other ocular diseases such as ocular trauma and surgery.Even when not coexisting with glaucoma, ocular trauma still acted as the third leading cause of BK in this study. Patients of these cases were mainly young or middle-aged, acting as main workers in the families, which reminded us that much more attention should be paid to the trauma. LI used to be a recommended treatment for affected and contralateral eyes in acute angle-closure glaucoma [7]. Shimazaki et al. [8] reported a strikingly large number of LI-related BK in Japan. They supposed that the difference in the rate of LI-relat...

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National Survey on Bullous Keratopathy in Japan

Abstract: Conclusion: The causes of BK in Japan are considerably different to those in other western countries. LI-related BKs showed a remarkably high number, whereas Fuchs` dystrophy was observed only rarely.

Cited by 110 publications

References 42 publications

Penetrating keratoplasty for bullous keratopathy after trabeculectomy

Penetrating keratoplasty for bullous keratopathy after trabeculectomy

Perfil do paciente com ceratopatia bolhosa pós-facectomia atendidos em hospital público

Analysis of causes of bullous keratopathy in East China: a 10-year retrospective study

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