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Penetrating keratoplasty and transscleral fixation of posterior chamber lens.

Identifieur interne : 002188 ( PubMed/Corpus ); précédent : 002187; suivant : 002189

Penetrating keratoplasty and transscleral fixation of posterior chamber lens.

Auteurs : E J Holland ; S M Daya ; A. Evangelista ; J M Ketcham ; A J Lubniewski ; D J Doughman ; S S Lane

Source :

American journal of ophthalmology [ 0002-9394 ] ; 1992.

RBID : pubmed:1642293

English descriptors

KwdEn :
- Adult, Aged, Aged, 80 and over, Cataract Extraction, Female, Humans, Intraocular Pressure, Keratoplasty, Penetrating, Lenses, Intraocular, Male, Middle Aged, Postoperative Complications, Sclera (surgery), Suture Techniques, Treatment Outcome, Visual Acuity.
MESH :
- surgery : Sclera.
- Adult, Aged, Aged, 80 and over, Cataract Extraction, Female, Humans, Intraocular Pressure, Keratoplasty, Penetrating, Lenses, Intraocular, Male, Middle Aged, Postoperative Complications, Suture Techniques, Treatment Outcome, Visual Acuity.

Abstract

We reviewed the outcome in 115 patients who underwent penetrating keratoplasty and transscleral fixation of a posterior chamber lens. One patient died soon after surgical procedures, and nine patients were lost to follow-up, leaving a cohort of 105 patients. Mean follow-up time was 26.8 months (range, six to 43 months). Visual acuity of 20/40 or better was found in 29 patients (27.6%) and 20/50 to 20/200 in 37 patients (35.2%). Reasons for poor visual outcome included cystoid macular edema in ten patients (9.5%), age-related macular degeneration in six patients (5.7%), and retinal detachment in four patients (3.8%). None of the patients developed lens decentration. There were no instances of hyphema and only one patient had a perioperative limited suprachoroidal hemorrhage. New-onset increase in intraocular pressure developed in 20 of 66 patients (30.3%). Analysis of the 39 patients with preoperative increase in intraocular pressure that required medical treatment demonstrated an improvement in 13 patients (33.3%), worsening in 12 patients (30.8%), and unchanged status in 14 patients (35.9%). The exposed haptic suture was covered by using one of the following three alternative methods: a conjunctival flap, a scleral flap, or a corneal tissue button. Exposure of the haptic suture through the conjunctiva was a complication in 21 patients (20%). Of these 16 (76.1%) occurred in the group with a conjunctival covering, five (23.8%) occurred in the group with a scleral flap, and none occurred in the corneal tissue button group. This study demonstrated that transscleral fixation of a posterior chamber lens is a viable option in the treatment of patients undergoing penetrating keratoplasty and intraocular lens implantation with absent capsular support.

PubMed: 1642293

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pubmed:1642293

Le document en format XML

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<author><name sortKey="Holland, E J" sort="Holland, E J" uniqKey="Holland E" first="E J" last="Holland">E J Holland</name>
<affiliation><nlm:affiliation>Department of Ophthalmology, University of Minnesota, Minneapolis 55455-0501.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Daya, S M" sort="Daya, S M" uniqKey="Daya S" first="S M" last="Daya">S M Daya</name>
</author>
<author><name sortKey="Evangelista, A" sort="Evangelista, A" uniqKey="Evangelista A" first="A" last="Evangelista">A. Evangelista</name>
</author>
<author><name sortKey="Ketcham, J M" sort="Ketcham, J M" uniqKey="Ketcham J" first="J M" last="Ketcham">J M Ketcham</name>
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<author><name sortKey="Lubniewski, A J" sort="Lubniewski, A J" uniqKey="Lubniewski A" first="A J" last="Lubniewski">A J Lubniewski</name>
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<author><name sortKey="Doughman, D J" sort="Doughman, D J" uniqKey="Doughman D" first="D J" last="Doughman">D J Doughman</name>
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<author><name sortKey="Lane, S S" sort="Lane, S S" uniqKey="Lane S" first="S S" last="Lane">S S Lane</name>
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<author><name sortKey="Holland, E J" sort="Holland, E J" uniqKey="Holland E" first="E J" last="Holland">E J Holland</name>
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<author><name sortKey="Daya, S M" sort="Daya, S M" uniqKey="Daya S" first="S M" last="Daya">S M Daya</name>
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<author><name sortKey="Evangelista, A" sort="Evangelista, A" uniqKey="Evangelista A" first="A" last="Evangelista">A. Evangelista</name>
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<author><name sortKey="Ketcham, J M" sort="Ketcham, J M" uniqKey="Ketcham J" first="J M" last="Ketcham">J M Ketcham</name>
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<author><name sortKey="Lubniewski, A J" sort="Lubniewski, A J" uniqKey="Lubniewski A" first="A J" last="Lubniewski">A J Lubniewski</name>
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<author><name sortKey="Doughman, D J" sort="Doughman, D J" uniqKey="Doughman D" first="D J" last="Doughman">D J Doughman</name>
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<series><title level="j">American journal of ophthalmology</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Cataract Extraction</term>
<term>Female</term>
<term>Humans</term>
<term>Intraocular Pressure</term>
<term>Keratoplasty, Penetrating</term>
<term>Lenses, Intraocular</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Postoperative Complications</term>
<term>Sclera (surgery)</term>
<term>Suture Techniques</term>
<term>Treatment Outcome</term>
<term>Visual Acuity</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Sclera</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Cataract Extraction</term>
<term>Female</term>
<term>Humans</term>
<term>Intraocular Pressure</term>
<term>Keratoplasty, Penetrating</term>
<term>Lenses, Intraocular</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Postoperative Complications</term>
<term>Suture Techniques</term>
<term>Treatment Outcome</term>
<term>Visual Acuity</term>
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<front><div type="abstract" xml:lang="en">We reviewed the outcome in 115 patients who underwent penetrating keratoplasty and transscleral fixation of a posterior chamber lens. One patient died soon after surgical procedures, and nine patients were lost to follow-up, leaving a cohort of 105 patients. Mean follow-up time was 26.8 months (range, six to 43 months). Visual acuity of 20/40 or better was found in 29 patients (27.6%) and 20/50 to 20/200 in 37 patients (35.2%). Reasons for poor visual outcome included cystoid macular edema in ten patients (9.5%), age-related macular degeneration in six patients (5.7%), and retinal detachment in four patients (3.8%). None of the patients developed lens decentration. There were no instances of hyphema and only one patient had a perioperative limited suprachoroidal hemorrhage. New-onset increase in intraocular pressure developed in 20 of 66 patients (30.3%). Analysis of the 39 patients with preoperative increase in intraocular pressure that required medical treatment demonstrated an improvement in 13 patients (33.3%), worsening in 12 patients (30.8%), and unchanged status in 14 patients (35.9%). The exposed haptic suture was covered by using one of the following three alternative methods: a conjunctival flap, a scleral flap, or a corneal tissue button. Exposure of the haptic suture through the conjunctiva was a complication in 21 patients (20%). Of these 16 (76.1%) occurred in the group with a conjunctival covering, five (23.8%) occurred in the group with a scleral flap, and none occurred in the corneal tissue button group. This study demonstrated that transscleral fixation of a posterior chamber lens is a viable option in the treatment of patients undergoing penetrating keratoplasty and intraocular lens implantation with absent capsular support.</div>
</front>
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<Month>08</Month>
<Day>31</Day>
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<DateCompleted><Year>1992</Year>
<Month>08</Month>
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<DateRevised><Year>2004</Year>
<Month>11</Month>
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<Article PubModel="Print"><Journal><ISSN IssnType="Print">0002-9394</ISSN>
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<Issue>2</Issue>
<PubDate><Year>1992</Year>
<Month>Aug</Month>
<Day>15</Day>
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<Title>American journal of ophthalmology</Title>
<ISOAbbreviation>Am. J. Ophthalmol.</ISOAbbreviation>
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<ArticleTitle>Penetrating keratoplasty and transscleral fixation of posterior chamber lens.</ArticleTitle>
<Pagination><MedlinePgn>182-7</MedlinePgn>
</Pagination>
<Abstract><AbstractText>We reviewed the outcome in 115 patients who underwent penetrating keratoplasty and transscleral fixation of a posterior chamber lens. One patient died soon after surgical procedures, and nine patients were lost to follow-up, leaving a cohort of 105 patients. Mean follow-up time was 26.8 months (range, six to 43 months). Visual acuity of 20/40 or better was found in 29 patients (27.6%) and 20/50 to 20/200 in 37 patients (35.2%). Reasons for poor visual outcome included cystoid macular edema in ten patients (9.5%), age-related macular degeneration in six patients (5.7%), and retinal detachment in four patients (3.8%). None of the patients developed lens decentration. There were no instances of hyphema and only one patient had a perioperative limited suprachoroidal hemorrhage. New-onset increase in intraocular pressure developed in 20 of 66 patients (30.3%). Analysis of the 39 patients with preoperative increase in intraocular pressure that required medical treatment demonstrated an improvement in 13 patients (33.3%), worsening in 12 patients (30.8%), and unchanged status in 14 patients (35.9%). The exposed haptic suture was covered by using one of the following three alternative methods: a conjunctival flap, a scleral flap, or a corneal tissue button. Exposure of the haptic suture through the conjunctiva was a complication in 21 patients (20%). Of these 16 (76.1%) occurred in the group with a conjunctival covering, five (23.8%) occurred in the group with a scleral flap, and none occurred in the corneal tissue button group. This study demonstrated that transscleral fixation of a posterior chamber lens is a viable option in the treatment of patients undergoing penetrating keratoplasty and intraocular lens implantation with absent capsular support.</AbstractText>
</Abstract>
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<MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000328">Adult</DescriptorName>
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<MeshHeading><DescriptorName MajorTopicYN="N" UI="D000368">Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D000369">Aged, 80 and over</DescriptorName>
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<MeshHeading><DescriptorName MajorTopicYN="Y" UI="D007910">Lenses, Intraocular</DescriptorName>
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<MeshHeading><DescriptorName MajorTopicYN="N" UI="D008297">Male</DescriptorName>
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<MeshHeading><DescriptorName MajorTopicYN="N" UI="D008875">Middle Aged</DescriptorName>
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<MeshHeading><DescriptorName MajorTopicYN="N" UI="D011183">Postoperative Complications</DescriptorName>
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<MeshHeading><DescriptorName MajorTopicYN="N" UI="D012590">Sclera</DescriptorName>
<QualifierName MajorTopicYN="Y" UI="Q000601">surgery</QualifierName>
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<MeshHeading><DescriptorName MajorTopicYN="Y" UI="D013536">Suture Techniques</DescriptorName>
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<MeshHeading><DescriptorName MajorTopicYN="N" UI="D016896">Treatment Outcome</DescriptorName>
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<MeshHeading><DescriptorName MajorTopicYN="N" UI="D014792">Visual Acuity</DescriptorName>
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Penetrating keratoplasty and transscleral fixation of posterior chamber lens.

Penetrating keratoplasty and transscleral fixation of posterior chamber lens.

Source :

English descriptors

Abstract

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