Corneal Re-Graft: Indications and Outcome MacEwen, Caroline J; Khan, Zia U H; Anderson, Elaine ...
Ophthalmic surgery, lasers & imaging retina,
10/1988, Letnik:
19, Številka:
10
Journal Article
Recenzirano
ABSTRACT
The results of 62 repeat penetrating keratoplasties (41 eyes) over a 10-year period are presented. The common indications for the primary graft include herpes simplex keratitis, Pseudophakic ...bullous keratopathy, aphakic bullous keratopathy, Fuch's endothelial dystrophy, and chronic ulceration. All cases of pseudophakic bullous keratopathy had the iris-clip type of intraocular lens. Graft failure was attributed to rejection, endothelial failure, recurrent ulceration, herpes simplex keratitis, melting, trauma, and recurrent dystrophy. At the end of the study period 28 grafts (68%) were clear and 13 (32%) were opaque. Visual improvement occurred in 28 eyes (68%), deterioration in four (10%), and six (15%) remained unchanged (visual result was not available in three eyes). These data are encouraging in terms of visual outcome and graft clarity in cases of repeat penetrating keratoplasty.
Comparison is made between the primary indications and outcome of these re-grafts and eyes requiring only one graft. Initial indications for grafting in both groups were similar, other than keratoconus, which was a significantly more common indication in eyes that required only one graft. Final visual results were better in those eyes undergoing only one graft, compared with those that required multiple surgery.
In the version of this article initially published, author Raphael Duivenvoorden’s last name was spelt incorrectly as Duivenwoorden. The error has been corrected in the HTML and PDF versions of the ...article.
Primed in MLC with allogeneic stimulators T cells acquire the capacity of expressing HLA-D and DR antigens and of stimulating the MLC response of autologous lymphocytes. When primed T cells from HTCs ...are used as stimulators, a bimodal distribution of responses with clear-cut "typing responses" and no significant "back stimulation" is observed. This pattern many be due to the expansion during priming of a population of HLD-D restricted suppressors since irradiated primed T cells inhibit the MLC responsiveness of HLA-A "compatible" lymphocytes. The development and size of such a population is not dependent, however, on the strength of the antigenic stimulus used for priming since no differences were seen between the pattern of reactions induced by T cells primed against HLA-D identical or HLA-D different cells. Primed OKT4+ and OKT8+ T cells share the capacity of expressing Ia antigens and of inducing "HLA-D restricted suppression." We suspected that a similar phenomenon accounted for the behavior of two HLA-D heterozygous cells as if they were HTCs. Although no suppression was found, the fact that these cells typed for their "silent" antigen when tested as responders, yet failed to express it when tested as stimulators, supports the theory that different genes control the MLC-responding and -stimulating capacities.
The results of 62 repeat penetrating keratoplasties (41 eyes) over a 10-year period are presented. The common indications for the primary graft include herpes simplex keratitis, pseudophakic bullous ...keratopathy, aphakic bullous keratopathy, Fuch's endothelial dystrophy, and chronic ulceration. All cases of pseudophakic bullous keratopathy had the iris-clip type of intraocular lens. Graft failure was attributed to rejection, endothelial failure, recurrent ulceration, herpes simplex keratitis, melting, trauma, and recurrent dystrophy. At the end of the study period 28 grafts (68%) were clear and 13 (32%) were opaque. Visual improvement occurred in 28 eyes (68%), deterioration in four (10%), and six (15%) remained unchanged (visual result was not available in three eyes). These data are encouraging in terms of visual outcome and graft clarity in cases of repeat penetrating keratoplasty. Comparison is made between the primary indications and outcome of these re-grafts and eyes requiring only one graft. Initial indications for grafting in both groups were similar, other than keratoconus, which was a significantly more common indication in eyes that required only one graft. Final visual results were better in those eyes undergoing only one graft, compared with those that required multiple surgery.
