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Artificial corneas versus donor corneas for repeat corneal transplants

Identifieur interne : 001702 ( Pmc/Curation ); précédent : 001701; suivant : 001703

Artificial corneas versus donor corneas for repeat corneal transplants

Auteurs : Esen K. Akpek [États-Unis] ; Majed Alkharashi [Arabie saoudite] ; Frank S. Hwang [États-Unis] ; Sueko M. Ng [États-Unis] ; Kristina Lindsley [États-Unis]

Source :

RBID : PMC:4270365

Abstract

Background

Individuals who have failed one or more full thickness penetrating keratoplasties (PKs) may be offered repeat corneal surgery using an artificial or donor cornea. An artificial or prosthetic cornea is known as a keratoprosthesis. Both donor and artificial corneal transplantations involve removal of the diseased and opaque recipient cornea (or the previously failed cornea) and replacement with another donor or prosthetic cornea.

Objectives

To assess the effectiveness of artificial versus donor corneas in individuals who have had one or more failed donor corneal transplantations.

Search methods

We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2013, Issue 10), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to November 2013), EMBASE (January 1980 to November 2013), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to November 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 27 November 2013.

Selection criteria

Two review authors independently assessed reports from the electronic searches to identify randomized controlled trials (RCTs) or controlled clinical trials (CCTs). We resolved discrepancies by discussion or consultation with a third review author.

Data collection and analysis

For discussion purposes, we assessed findings from observational cohort studies and non-comparative case series. No data synthesis was performed.

Main results

We did not identify any RCTs or CCTs comparing artificial corneas with donor corneas for repeat corneal transplantations.

Authors’ conclusions

The optimal management for those individuals who have failed a conventional corneal transplantation is not known. Currently, in some centers, artificial corneal devices routinely are recommended after just one graft failure, and in others, not until after multiple graft failures, or not at all. To date, there have been no controlled trials comparing the visual outcomes and complications of artificial corneal devices (particularly the Boston type 1 keratoprosthesis which is the most commonly implanted artificial corneal device) with repeat donor corneal transplantation, in order to guide surgeons and their patients. It is apparent that such a trial is needed and would offer significant benefit to an ever-increasing pool of people with visual disability due to corneal opacification, most of whom are still in productive stages of their lives.


Url:
DOI: 10.1002/14651858.CD009561.pub2
PubMed: 25372407
PubMed Central: 4270365

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PMC:4270365

Le document en format XML

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<sec id="S1">
<title>Background</title>
<p id="P1">Individuals who have failed one or more full thickness penetrating keratoplasties (PKs) may be offered repeat corneal surgery using an artificial or donor cornea. An artificial or prosthetic cornea is known as a keratoprosthesis. Both donor and artificial corneal transplantations involve removal of the diseased and opaque recipient cornea (or the previously failed cornea) and replacement with another donor or prosthetic cornea.</p>
</sec>
<sec id="S2">
<title>Objectives</title>
<p id="P2">To assess the effectiveness of artificial versus donor corneas in individuals who have had one or more failed donor corneal transplantations.</p>
</sec>
<sec id="S3">
<title>Search methods</title>
<p id="P3">We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2013, Issue 10), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to November 2013), EMBASE (January 1980 to November 2013), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to November 2013), the
<italic>meta</italic>
Register of Controlled Trials (
<italic>m</italic>
RCT) (
<ext-link ext-link-type="uri" xlink:href="www.controlled-trials.com">www.controlled-trials.com</ext-link>
), ClinicalTrials.gov (
<ext-link ext-link-type="uri" xlink:href="www.clinicaltrials.gov">www.clinicaltrials.gov</ext-link>
) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (
<ext-link ext-link-type="uri" xlink:href="www.who.int/ictrp/search/en">www.who.int/ictrp/search/en</ext-link>
). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 27 November 2013.</p>
</sec>
<sec id="S4">
<title>Selection criteria</title>
<p id="P4">Two review authors independently assessed reports from the electronic searches to identify randomized controlled trials (RCTs) or controlled clinical trials (CCTs). We resolved discrepancies by discussion or consultation with a third review author.</p>
</sec>
<sec id="S5">
<title>Data collection and analysis</title>
<p id="P5">For discussion purposes, we assessed findings from observational cohort studies and non-comparative case series. No data synthesis was performed.</p>
</sec>
<sec id="S6">
<title>Main results</title>
<p id="P6">We did not identify any RCTs or CCTs comparing artificial corneas with donor corneas for repeat corneal transplantations.</p>
</sec>
<sec id="S7">
<title>Authors’ conclusions</title>
<p id="P7">The optimal management for those individuals who have failed a conventional corneal transplantation is not known. Currently, in some centers, artificial corneal devices routinely are recommended after just one graft failure, and in others, not until after multiple graft failures, or not at all. To date, there have been no controlled trials comparing the visual outcomes and complications of artificial corneal devices (particularly the Boston type 1 keratoprosthesis which is the most commonly implanted artificial corneal device) with repeat donor corneal transplantation, in order to guide surgeons and their patients. It is apparent that such a trial is needed and would offer significant benefit to an ever-increasing pool of people with visual disability due to corneal opacification, most of whom are still in productive stages of their lives.</p>
</sec>
</div>
</front>
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<journal-id journal-id-type="nlm-journal-id">100909747</journal-id>
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<article-title>Artificial corneas versus donor corneas for repeat corneal transplants</article-title>
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<contrib contrib-type="author">
<name>
<surname>Akpek</surname>
<given-names>Esen K</given-names>
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<name>
<surname>Alkharashi</surname>
<given-names>Majed</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
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<name>
<surname>Hwang</surname>
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</name>
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<name>
<surname>Ng</surname>
<given-names>Sueko M</given-names>
</name>
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<contrib contrib-type="author">
<name>
<surname>Lindsley</surname>
<given-names>Kristina</given-names>
</name>
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Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA</aff>
<aff id="A2">
<label>2</label>
Department of Ophthalmology, King Saud University, Riyadh, Saudi Arabia</aff>
<aff id="A3">
<label>3</label>
Cornea, External Disease and Refractive Surgery, Kresge Eye Institute, Detroit, Michigan, USA</aff>
<aff id="A4">
<label>4</label>
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA</aff>
<author-notes>
<corresp id="FN1">Contact address: Esen K Akpek, Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Maumenee #317, Baltimore, MD, 21287, USA.
<email>esakpek@jhmi.edu</email>
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<day>2</day>
<month>12</month>
<year>2014</year>
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<year>2014</year>
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<year>2014</year>
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<volume>11</volume>
<fpage>CD009561</fpage>
<lpage>CD009561</lpage>
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<copyright-statement>Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.</copyright-statement>
<copyright-year>2014</copyright-year>
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<abstract>
<sec id="S1">
<title>Background</title>
<p id="P1">Individuals who have failed one or more full thickness penetrating keratoplasties (PKs) may be offered repeat corneal surgery using an artificial or donor cornea. An artificial or prosthetic cornea is known as a keratoprosthesis. Both donor and artificial corneal transplantations involve removal of the diseased and opaque recipient cornea (or the previously failed cornea) and replacement with another donor or prosthetic cornea.</p>
</sec>
<sec id="S2">
<title>Objectives</title>
<p id="P2">To assess the effectiveness of artificial versus donor corneas in individuals who have had one or more failed donor corneal transplantations.</p>
</sec>
<sec id="S3">
<title>Search methods</title>
<p id="P3">We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2013, Issue 10), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to November 2013), EMBASE (January 1980 to November 2013), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to November 2013), the
<italic>meta</italic>
Register of Controlled Trials (
<italic>m</italic>
RCT) (
<ext-link ext-link-type="uri" xlink:href="www.controlled-trials.com">www.controlled-trials.com</ext-link>
), ClinicalTrials.gov (
<ext-link ext-link-type="uri" xlink:href="www.clinicaltrials.gov">www.clinicaltrials.gov</ext-link>
) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (
<ext-link ext-link-type="uri" xlink:href="www.who.int/ictrp/search/en">www.who.int/ictrp/search/en</ext-link>
). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 27 November 2013.</p>
</sec>
<sec id="S4">
<title>Selection criteria</title>
<p id="P4">Two review authors independently assessed reports from the electronic searches to identify randomized controlled trials (RCTs) or controlled clinical trials (CCTs). We resolved discrepancies by discussion or consultation with a third review author.</p>
</sec>
<sec id="S5">
<title>Data collection and analysis</title>
<p id="P5">For discussion purposes, we assessed findings from observational cohort studies and non-comparative case series. No data synthesis was performed.</p>
</sec>
<sec id="S6">
<title>Main results</title>
<p id="P6">We did not identify any RCTs or CCTs comparing artificial corneas with donor corneas for repeat corneal transplantations.</p>
</sec>
<sec id="S7">
<title>Authors’ conclusions</title>
<p id="P7">The optimal management for those individuals who have failed a conventional corneal transplantation is not known. Currently, in some centers, artificial corneal devices routinely are recommended after just one graft failure, and in others, not until after multiple graft failures, or not at all. To date, there have been no controlled trials comparing the visual outcomes and complications of artificial corneal devices (particularly the Boston type 1 keratoprosthesis which is the most commonly implanted artificial corneal device) with repeat donor corneal transplantation, in order to guide surgeons and their patients. It is apparent that such a trial is needed and would offer significant benefit to an ever-increasing pool of people with visual disability due to corneal opacification, most of whom are still in productive stages of their lives.</p>
</sec>
</abstract>
</article-meta>
</front>
</pmc>
</record>

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