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      Penetrating Keratoplasty Combined with Vitreoretinal Surgery for Severe Ocular Injury with Blood-Stained Cornea and No Light Perception

      research-article
      , , , ,
      Ophthalmologica
      S. Karger AG
      Eye injuries, Vitrectomy, Penetrating keratoplasty

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          Abstract

          Objective: To evaluate the effects of treatment of severe ocular injury with blood-stained cornea and no light perception by combined penetrating keratoplasty and vitreoretinal surgery, and to analyze the relevant factors. Methods: Records of 7 severely injured eyes of 7 patients with blood-stained cornea and no light perception who underwent penetrating keratoplasty combined with vitrectomy using a temporary keratoprosthesis were evaluated retrospectively. The preoperative visual acuity was no light perception in all injured eyes with a mean intraocular pressure of 3 mm Hg and a range from 2 to 5 mm Hg. The average interval from emergency wound closure to vitrectomy was 18 days with a range from 12 to 21 days. The mean follow-up was 28 months with a range from 26 to 30 months. Results: The postoperative visual acuity was better than light perception in 5 eyes with the best corrected visual acuity from light perception to 0.06. The retina was attached in 5 eyes. The postoperative intraocular pressure ranged from 5 to 15 mm Hg with a mean of 12 mm Hg; it was significantly higher than the preoperative one (p < 0.05). The postoperative complications mainly included temporary intraocular elevation (1 eye), corneal neovascularization (4 eyes), corneal rejection (4 eyes), retinal detachment (2 eyes) and ocular atrophy (2 eyes). Conclusion: Penetrating keratoplasty combined with vitrectomy using a temporary keratoprosthesis is a safe and effective method in treating severe ocular injury with blood-stained cornea and no light perception.

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          Most cited references3

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          Outcome of vitreoretinal surgery and penetrating keratoplasty using temporary keratoprosthesis.

          The use of a temporary keratoprosthesis has allowed earlier surgical intervention in eyes with coexisting vitreoretinal and corneal disease. We analyzed our experience with this type of surgery.
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            • Record: found
            • Abstract: found
            • Article: not found

            Outcome of combined penetrating keratoplasty with vitreoretinal surgery for management of severe ocular injuries.

            To assess the effectiveness of a combined procedure (pars plana vitrectomy with temporary keratoprosthesis, vitreoretinal surgery, and penetrating keratoplasty) and to determine which factors influence corneal transplant success rates. Records for 34 severely injured eyes of 31 consecutive patients who underwent penetrating keratoplasty in combination with vitreoretinal surgery between 1991 and 1998, with a follow-up of at least 12 months, were evaluated retrospectively. Analysis was focused on ocular history, functional and anatomic anterior and posterior segment outcome, and complications. Penetrating keratoplasty was performed in 10 eyes (29%) within 8 weeks of trauma and in 24 eyes (71%) as a secondary procedure. Initial improvement in visual acuity (VA) was achieved in 47% of eyes; at the end of the follow-up, 74% of the eyes had attained equal or better VA than the initial postsurgical VA. Reasons for poor final VA were hypotony or phthisis (35%) and recurrent retinal detachment (11%). Corneal grafts remained clear for 1 year in 65% of eyes. Transplant failure was less in eyes that did not need a permanent silicone oil tamponade, when the retina was attached before surgery, and in eyes that were grafted later after trauma and received no further surgery. These were some conditions that were associated with a longer mean graft survival time, but without statistical significance. There was no difference in eyes according to the trauma mechanism, preoperative intraocular pressure, or graft size. Penetrating keratoplasty in severely injured eyes is often complicated by ciliary body malfunction and secondary transplant failure. Although the functional outcome of a combined procedure is limited by primary and secondary tissue destruction, preserving ambulatory vision is possible and thus improves the quality of life, at least in patients with single remaining eyes.
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              • Article: not found

              Results of penetrating keratoplasty in bullous silicone oil keratopathy.

              To evaluate the results of penetrating keratoplasty (PK) in bullous silicone oil keratopathy (BSK).
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                Author and article information

                Journal
                OPH
                Ophthalmologica
                10.1159/issn.0030-3755
                Ophthalmologica
                S. Karger AG
                0030-3755
                1423-0267
                2006
                May 2006
                09 May 2006
                : 220
                : 3
                : 186-189
                Affiliations
                Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
                Article
                91763 Ophthalmologica 2006;220:186–189
                10.1159/000091763
                16679794
                d7ab6bcf-4174-4665-a936-6ddda491ff45
                © 2006 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                : 09 December 2005
                Page count
                Tables: 1, References: 10, Pages: 4
                Categories
                Original Paper

                Vision sciences,Ophthalmology & Optometry,Pathology
                Eye injuries,Vitrectomy,Penetrating keratoplasty

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