To analyse the outcome of Triple procedure(Combined penetrating keratoplasty,cataract extraction and intraocular lens implantation)is a surgical technique for visually disabling corneal conditions with associated cata...To analyse the outcome of Triple procedure(Combined penetrating keratoplasty,cataract extraction and intraocular lens implantation)is a surgical technique for visually disabling corneal conditions with associated cataract.METHODS:The medical records of 120 patients who underwent triple procedure between January 2007 and December 2011 in terms of demographic data,past ophthalmic history,indications for surgery were retrospectively reviewed.Salient preoperative data included the initial visual acuity at the time of presentation,slit lamp findings of cornea(scar,haze,vascularisation,stromal folds with bullae),anterior chamber,lens details,intraocular pressure status,posterior segment examination with the help of indirect ophthalmoscope or B scan ultrasongraphy.RESULTS:A total of 120 corneal triple procedures performed were included in this study.Of 120 patients,25(20.83%)were male and 95(79.17%)were female.Mean age of these patients was 42.45+/-15.85 years(range 9 to 75 years).The mean postoperative follow up was 15.08+/-12.8 months(range,1.5 to 49 months).Failed therapeutic grafts(42.5%)-was the common indication found for surgery.Preoperatively,intraocular pressure was increased in 11(9.16%)patients.Conventional triple procedure in terms of combined penetrating keratoplasty with extracapsular cataract extraction with intraocular lens implantation(PK+ECCE+IOL)was performed in 114(95%)eyes,01(0.83%)eye underwent keratoplasty with phacoemulsification with intraocular lens implantation(PK+PE+IOL),and secondary intraocular lens implantation(PK+IOL)in 05(4.17%)eyes.CONCLUSION:Triple procedure is an effective surgical option in corneal diseases associated with cataract.It provides an optimal visual and refractive outcome especially in high risk grafts situation.展开更多
Because of the low incidence of immunological rejection,deep anterior lamellar keratoplasty(DALK)is currently the preferred treatment for macular corneal dystrophy(MCD).However,there were few reports about whether the...Because of the low incidence of immunological rejection,deep anterior lamellar keratoplasty(DALK)is currently the preferred treatment for macular corneal dystrophy(MCD).However,there were few reports about whether the consistent results were obtained when performing DALK in both eyes for MCD,especially when the corneal grafts were taken from different donors.Also,there were few reports about whether the stromal graft rejection occurred typically in both eyes in MCD with DALK.This case may represent the first report of an unusual and misleading manifestation of stromal graft rejection after uneventful DALK with big bubble technique in the fellow eye in MCD.A 32-year-old healthy man with MCD underwent bilateral uneventful DALK with a big bubble technique in the left eye in January and the right eye in July,the corneal grafts were taken from different donors.There was an atypical allograft rejection that occurred in the right eye and none in the left eye;although a timely diagnosis of graft rejection revealed following aqueous determination,it could not be reversed and underwent PK finally.The purpose of this case report is to illustrate the identification of atypical allograft rejection after DALK in the fellow eye,the significance of aqueous detection in the diagnosis of graft rejection,the choosing of grafts,and the timing of bilateral corneal transplantation in patients with MCD.展开更多
文摘To analyse the outcome of Triple procedure(Combined penetrating keratoplasty,cataract extraction and intraocular lens implantation)is a surgical technique for visually disabling corneal conditions with associated cataract.METHODS:The medical records of 120 patients who underwent triple procedure between January 2007 and December 2011 in terms of demographic data,past ophthalmic history,indications for surgery were retrospectively reviewed.Salient preoperative data included the initial visual acuity at the time of presentation,slit lamp findings of cornea(scar,haze,vascularisation,stromal folds with bullae),anterior chamber,lens details,intraocular pressure status,posterior segment examination with the help of indirect ophthalmoscope or B scan ultrasongraphy.RESULTS:A total of 120 corneal triple procedures performed were included in this study.Of 120 patients,25(20.83%)were male and 95(79.17%)were female.Mean age of these patients was 42.45+/-15.85 years(range 9 to 75 years).The mean postoperative follow up was 15.08+/-12.8 months(range,1.5 to 49 months).Failed therapeutic grafts(42.5%)-was the common indication found for surgery.Preoperatively,intraocular pressure was increased in 11(9.16%)patients.Conventional triple procedure in terms of combined penetrating keratoplasty with extracapsular cataract extraction with intraocular lens implantation(PK+ECCE+IOL)was performed in 114(95%)eyes,01(0.83%)eye underwent keratoplasty with phacoemulsification with intraocular lens implantation(PK+PE+IOL),and secondary intraocular lens implantation(PK+IOL)in 05(4.17%)eyes.CONCLUSION:Triple procedure is an effective surgical option in corneal diseases associated with cataract.It provides an optimal visual and refractive outcome especially in high risk grafts situation.
文摘Because of the low incidence of immunological rejection,deep anterior lamellar keratoplasty(DALK)is currently the preferred treatment for macular corneal dystrophy(MCD).However,there were few reports about whether the consistent results were obtained when performing DALK in both eyes for MCD,especially when the corneal grafts were taken from different donors.Also,there were few reports about whether the stromal graft rejection occurred typically in both eyes in MCD with DALK.This case may represent the first report of an unusual and misleading manifestation of stromal graft rejection after uneventful DALK with big bubble technique in the fellow eye in MCD.A 32-year-old healthy man with MCD underwent bilateral uneventful DALK with a big bubble technique in the left eye in January and the right eye in July,the corneal grafts were taken from different donors.There was an atypical allograft rejection that occurred in the right eye and none in the left eye;although a timely diagnosis of graft rejection revealed following aqueous determination,it could not be reversed and underwent PK finally.The purpose of this case report is to illustrate the identification of atypical allograft rejection after DALK in the fellow eye,the significance of aqueous detection in the diagnosis of graft rejection,the choosing of grafts,and the timing of bilateral corneal transplantation in patients with MCD.
