1.Silicone oil keratopathy.
Woo Chul CHOI ; Sang Kyung CHOI ; Jin Hak LEE
Korean Journal of Ophthalmology 1993;7(2):65-69
Light microscopy and electron microscopic examination were carried out on the corneal buttons of two patients who required penetrating keratoplasty for treatment of corneal complication following the intraocular injection of silicone oil to repair recurrent retinal detachments in aphakic eyes. Light microscopic examination demonstrated increased cellularity and irregularity of collagen fibers of stromal layer, defect of endothelial cell layer and endothelial degeneration. Electron microscopy examination demonstrated marked decrease in endothelial cell population density, accompanied by flattening and thinning of the remaining cells and attenuation of cell borders. There were silicone droplets in the endothelial cell layer and collagenous layer posterior to endothelial layer. These findings are well correlated to clinical manifestation and are thought to be rather due to barrier effect of silicone oil than direct toxicity.
Adult
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Corneal Diseases/*chemically induced/pathology/surgery
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Descemet Membrane/ultrastructure
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Endothelium, Corneal/drug effects/surgery/ultrastructure
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Humans
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Keratoplasty, Penetrating
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Male
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Recurrence
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Retinal Detachment/surgery
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Silicone Oils/*adverse effects
2.Role of dendritic cells in graft rejection after penetrating keratoplasty.
Lang BAI ; Xiao-He LU ; Sen-Tao DANG ; Jin ZHOU
Journal of Southern Medical University 2007;27(1):72-74
OBJECTIVETo gain insight into the role of dendritic cells in graft rejection following penetrating keratoplasty by investigating their distribution in rat cornea.
METHODSOrthotopical corneal transplantation was performed and immunohistochemical staining of the whole-mount cornea and the spleen tissue specimen employed to determine the distribution of the dendritic cells in the cornea.
RESULTSGraft rejection occurred in all rats following the transplantation. No OX-62(+) dendritic cells were found in normal cornea but they were present in the epithelium of the cornea graft with allograft rejection.
CONCLUSIONOX-62(+) dendritic cells presenting in the rejected cornea may be related to acute graft rejection after penetrating keratoplasty.
Animals ; Cornea ; immunology ; pathology ; surgery ; Dendritic Cells ; immunology ; physiology ; Female ; Graft Rejection ; etiology ; immunology ; physiopathology ; Keratoplasty, Penetrating ; adverse effects ; methods ; Male ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar
3.Effects of Cataract Surgery on Endothelium in Transplanted Corneal Grafts: Comparison of Extracapsular Cataract Extraction and Phacoemulsification for Complicated Cataract after Penetrating Keratoplasty.
Chinese Medical Journal 2016;129(17):2096-2101
BACKGROUNDThe endothelium should be carefully evaluated when choosing a surgical technique for cataract removal. Therefore, we aimed to study the effects of different cataract surgery techniques on endothelial cell loss in transplanted corneal grafts.
METHODSA total of 54 patients who received complicated cataract surgery in post-penetrating keratoplasty (PKP) eyes at the Shandong Eye Institute between February 2001 and June 2014 were included, and clinical records were reviewed. Baseline demographic details, clinical characteristics, endothelial cell density (ECD), and best-corrected visual acuity (BCVA) were recorded. Wilcoxon rank-sum test and Wilcoxon signed-rank test were used to test the equality of medians. A regression model was constructed to compare the reduced rate of ECD.
RESULTSOf the 54 eyes included in this study, extracapsular cataract extraction (ECCE) was performed in 34 eyes of 33 patients (ECCE group) whereas phacoemulsification was performed in 20 eyes of 20 patients (phacoemulsification group). There was no significant difference in the median age (P = 0.081) or preoperative ECD (P = 0.585) between the two groups. At 6 months after cataract surgery, ECD in ECCE group was significantly higher than that in phacoemulsification group (P = 0.043). In addition, the endothelial cell loss rate in ECCE group was significantly lower than that in phacoemulsification group at 2 months (P = 0.018), 4 months (P < 0.001), and 6 months (P < 0.001) after cataract surgery. Endothelial cell loss rate after cataract surgery increased over the 6-month study duration in both ECCE group (P < 0.001) and phacoemulsification group (P < 0.001), but phacoemulsification resulted in a greater reduction in ECD than that of ECCE in transplanted corneal grafts (P < 0.001). There was no significant difference in postoperative BCVA between the two groups (P = 0.065).
CONCLUSIONECCE is more suitable than phacoemulsification in cataract surgery in complicated cataract after PKP.
Adolescent ; Adult ; Aged ; Cataract ; pathology ; Cataract Extraction ; adverse effects ; Corneal Endothelial Cell Loss ; diagnosis ; etiology ; pathology ; Endothelium, Corneal ; pathology ; Female ; Humans ; Keratoplasty, Penetrating ; adverse effects ; Male ; Middle Aged ; Phacoemulsification ; adverse effects ; Retrospective Studies ; Young Adult
4.Laser-assisted In Situ Keratomileusis for Correction of Astigmatism and Increasing Contact Lens Tolerance after Penetrating Keratoplasty.
Chang Hyun PARK ; Su Young KIM ; Man Soo KIM
Korean Journal of Ophthalmology 2014;28(5):359-363
PURPOSE: To determine effectiveness of laser-assisted in situ keratomileusis (LASIK) in the treatment of astigmatism following penetrating keratoplasty (PK). METHODS: We performed a retrospective review of medical records of patients who underwent LASIK following PK and had over 1 year of follow-up data. RESULTS: Twenty-six patients (26 pairs of eyes) underwent LASIK following PK. Mean age of the patients at the time of LASIK was 40.7 years (range, 26 to 72 years). Following LASIK, the mean cylinder was reduced by 2.4 diopters and mean reduction of cylinder after LASIK was 65.4% from the preoperative values at the last follow-up visit. Uncorrected visual acuity became 20 / 50 or better in 69.2% of the eyes after LASIK. Best-corrected visual acuity became 20 / 50 or better in 73.1% of the eyes after LASIK. All of them were intolerable to contact lenses before LASIK. After LASIK, 6 pairs (23.1%) did not need to use contact lenses and 18 pairs (69.2%) were tolerable to using contact lenses or spectacles. There were no significant endothelial cell density changes 12 months after LASIK (p = 0.239). CONCLUSIONS: LASIK is effective in the treatment of astigmatism following PK and increases contact lens and spectacle tolerance.
Adult
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Aged
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Astigmatism/etiology/physiopathology/*surgery
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*Contact Lenses/utilization
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Corneal Topography
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Female
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Humans
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Keratomileusis, Laser In Situ/*methods
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Keratoplasty, Penetrating/*adverse effects
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Lasers, Excimer/*therapeutic use
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Male
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Middle Aged
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Refraction, Ocular/physiology
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Retrospective Studies
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Vision, Binocular/physiology
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Visual Acuity/physiology
5.Development of Toxic Anterior Segment Syndrome Immediately after Uneventful Phaco Surgery.
Jin Seok CHOI ; Kyung Hwan SHYN
Korean Journal of Ophthalmology 2008;22(4):220-227
PURPOSE: We report on 15 cases of suspected toxic anterior segment syndrome after uneventful phaco surgery. METHODS: We retrospectively reviewed the charts of patients who had developed toxic anterior segment syndrome (TASS) after uneventful phacoemulsification for senile cataracts between April and December of 2005. Clinical features and all possible causes were investigated including irrigating solutions or drugs, surgical instruments or intraocular lenses, sterilization techniques for instruments, or any other accompanying disease. RESULTS: The patients consisted of 2 males and 13 females with an average age of 64.7+/-10.9 years. Five different surgeons had performed their phaco surgeries. No abnormal preoperative or operative findings were reported. Nevertheless, all 15 patients developed a moderate degree of corneal edema. Ordinary treatments were not helpful. We suspect that lack of sterilization resulted in the development of the syndrome, because after ethylene oxide gas sterilization was replaced with autoclaving, no such incidents have occurred. CONCLUSIONS: Toxic anterior segment syndrome requires special attention and thorough management, including sterilization of reused surgical instruments.
Aged
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Aged, 80 and over
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Anterior Eye Segment/*pathology
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Corneal Edema/*etiology/pathology/surgery
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Endophthalmitis/*etiology/pathology/surgery
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Endotoxins/adverse effects
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Female
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Humans
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Keratoplasty, Penetrating
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*Lens Implantation, Intraocular
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Male
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Middle Aged
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*Phacoemulsification
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*Postoperative Complications
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Retrospective Studies
;
Syndrome
6.Factors Affecting Treatment Outcome of Graft Infection Following Penetrating Keratoplasty.
Mi Sun SUNG ; Won CHOI ; In Cheon YOU ; Kyung Chul YOON
Korean Journal of Ophthalmology 2015;29(5):301-308
PURPOSE: To evaluate the factors affecting treatment outcome of graft infection following penetrating keratoplasty (PKP). METHODS: In this retrospective study, 28 patients who underwent PKP between January 2005 and January 2013 and who were diagnosed with graft infection were classified into a treatment success group or a treatment failure group. Demographic and clinical characteristics, as well as the results of the microbiologic investigation, were analyzed and compared. A subsequent binary logistic regression analysis was performed to identify the prognostic factors affecting treatment outcome. RESULTS: Graft infection occurred at a mean of 38.29 +/- 36.16 months (range, 1 to 96 months) after PKP. Seventeen patients developed bacterial keratitis, and 11 patients developed fungal keratitis. Overall, of the 28 patients, nine (32.1%) were classified in the treatment failure group. Multivariate analysis identified pre-existing graft failure (p = 0.019), interval longer than 72 hours between donor death and PKP (p = 0.010), and fungal infection (p = 0.026) as significant risk factors for treatment failure. CONCLUSIONS: Pre-existing graft failure, extended interval between donor death and PKP, and fungal infection were important risk factors for treatment failure of graft infection following PKP.
Adult
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Aged
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Aged, 80 and over
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Eye Infections, Bacterial/diagnosis/*etiology
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Eye Infections, Fungal/diagnosis/*etiology
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Female
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*Graft Survival
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Humans
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Keratoplasty, Penetrating/*adverse effects
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Male
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Middle Aged
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Prognosis
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Retrospective Studies
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Risk Factors
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Surgical Wound Infection/diagnosis/*etiology
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Treatment Outcome
7.Implantation of posterior chamber intraocular lenses by suture fixation without capsular and zonular support.
Korean Journal of Ophthalmology 1989;3(2):90-93
We implanted sulcus-fixated posterior chamber intraocular lenses (PCL) in three cataractous, six aphakic, and four eyes during penetrating keratoplasty due to corneal opacity in the absence of capsular and zonular support. This technique has been successfully performed in all cases and produced good visual outcome in 12 eyes (93%). In four eyes which had penetrating keratoplasty and the fixation of PCL, one developed vitreous hemorrhage and one developed corneal graft rejection.
Adult
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Aged
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Aphakia/complications/surgery
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Cataract Extraction
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Corneal Opacity/complications/surgery
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Eye Hemorrhage/etiology
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Female
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Follow-Up Studies
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Graft Rejection
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Humans
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Keratoplasty, Penetrating
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Lens Capsule, Crystalline/surgery
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*Lenses, Intraocular/adverse effects
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Male
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Methods
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Middle Aged
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Refraction, Ocular
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*Suture Techniques
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Visual Acuity
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Vitreous Body/blood supply