Abstract:
BACKGROUND:Data from national graft registries suggests a limited prognosis in the group of all repeat keratoplasties. This group might rather consist mostly of cases already classified as high risk in the first place, however. Thus, repeat keratoplasties in normal risk indications might have a substantially better prognosis. In particular, any specific increase of immune reactions following repeat keratoplasty as compared to first keratoplasties is unknown at present. Furthermore, the contribution of chronic endothelial cell loss to graft failure following repeat keratoplasty has not yet been investigated. The aim of this analysis on a large retrospective cohort is to estimate the incidence of graft rejections and failures als well as chronic endothelial cell loss following repeat keratoplasty. PATIENTS AND METHODS:All keratoplasties that had been performed from 1986 to 2006 at the University Eye Hospital Düsseldorf were selected for the 4 most relevant indications. A total of 2073 first keratoplasties and 236 repeat keratoplasties for keratoconus, Fuchs endothelial dystrophy, bullous keratopathy and herpetic corneal scars were included in the analysis. For each indication, the incidence of graft rejections and failures was compared between first and repeat keratoplasty using the Kaplan-Meier method and log-rank test. Endothelial cell loss was quantified by means of exponential regression analysis in the cases without immune reactions. Data of 65 repeat keratoplasties and 532 initial keratoplasties were available for analysis in a generalised linear model. RESULTS:After five years, the risk of graft rejections was not increased in repeat keratoplasties for keratoconus as compared to initial keratoplasties. In Fuchs endothelial dystrophy (p = 0.03) and herpetic corneal scars (n. s.) an increase of 11 % was observed. In bullous keratopathy the increase was as high as 24 % (p < or = 0.01). Irreversible graft failure increased by 4 % in keratoconus, 11 % in Fuchs endothelial dystrophy, 7 % in herpetic eye disease and by 31 % in bullous keratopathy. Only the latter difference reached statistical significance (p < or = 0.01), however. In this group, chronic endothelial cell loss was accelerated to a great extent as well: annual cell loss averaged 43 % in repeat keratoplasties whereas this rate was as low as 20 % for the initial surgery (p = 0.01). In the other indications, acceleration of cell loss in repeat keratoplasties as compared to the first transplantation did not exceed 12 % (p = 0.03). CONCLUSIONS:The prognosis of repeat keratoplasties for keratoconus does not seem to fall short of that of initial keratoplasty. A slight deterioration can be assumed in Fuchs endothelial and herpetic eye disease dystrophy. Repeat keratoplasties in initial bullous keratopathy, however, seem to have a substantially poorer prognosis with respect to immune reactions, graft survival and chronic endothelial cell loss.
journal_name
Klin Monbl Augenheilkdjournal_title
Klinische Monatsblatter fur Augenheilkundeauthors
Böhringer D,Reinhard Tdoi
10.1055/s-2008-1027127subject
Has Abstractpub_date
2008-01-01 00:00:00pages
50-6issue
1eissn
0023-2165issn
1439-3999journal_volume
225pub_type
杂志文章abstract::Ocular radiotherapy has considerably improved during the last 60 years. It allows very often, not only to save an eye, but also to maintain a useful function. But it is only one single element, although important, in our fight against intraocular tumors. ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1979-06-01 00:00:00
abstract::A 31-year-old patient was buried at canal-building. He sustained Purtscher's retinopathy on his left eye. A fluorescein-angiography displayed six years after the trauma a large neovascular frond and intraretinal neovascular network. These findings demonstrate the severe lesions of the retinal microcirculation caused b...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1976-06-01 00:00:00
abstract:BACKGROUND:The correction of lower eyelid retraction remains a challenge with established techniques having disadvantages. A recently described alternative is implantation of an ultrathin high density porous polyethylene lower eyelid spacer (Medpor LES). We report our experience on implanting this Medpor LES, especiall...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 临床试验,杂志文章
doi:10.1055/s-2006-926508
更新日期:2006-07-01 00:00:00
abstract::The present report describes clinical findings in 13 patients with Sturge-Weber syndrome, 11 of whom had glaucoma (22-52 mm Hg). The episcleral venous pressure (EVP) was high in all glaucomatous eyes (14-23 mm Hg). Tonography showed a marked decrease in outflow facility. The observations suggest that glaucoma in Sturg...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1050508
更新日期:1987-10-01 00:00:00
abstract:BACKGROUND:Pseudomonas aeruginosa is the most common cause of bacterial-associated keratitis in soft contact lens wearers, due to wrong use of soft contact lenses. Problems are often severe corneal ulcers and even corneal perforations. We report on a soft contact lens wearer with credibly correct use of soft contact le...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2003-812639
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:To investigate the structural basis for functional deficits in infantile strabismus we used a neuroanatomic tracer and a histochemical label to examine the primary visual cortex (area V1) of adult esotropic macaque monkeys. ANIMALS AND METHODS:The animals had developed natural esotropia in the first months ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1035162
更新日期:1996-01-01 00:00:00
abstract:PURPOSE:The purpose of this study was to assess the vasoconstrictor effect of the prostaglandin F2 alpha analog latanoprost in isolated porcine ciliary arteries. MATERIAL AND METHODS:With a myograph system to measure isometric forces, porcine ciliary arteries were exposed, in a cumulative manner, to increasing concent...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2001-15904
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Until now there were no statistical data on the incidence and the prevalence of eye burns. Therefore we studied all patients coming to our hospital from the area of Aachen with eye burns during the time from September 1990 until August 1991. PATIENTS AND METHODS:All patients underwent a standardized examina...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1045646
更新日期:1993-07-01 00:00:00
abstract:PURPOSE:The aim of this study was to evaluate tumour regression in a large series of choroidal melanomas, which were treated with three different eye-sparing treatment modalities. PATIENTS AND METHODS:Retrospective review of the treatment results in all eyes with malignant choroidal melanoma, which were treated in the...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0029-1245224
更新日期:2010-04-01 00:00:00
abstract::The microsurgical processing of longterm preserved tissue is still a problem for lamellar and perforating keratoplasties. Advantages of donor tissue cut with rotortrephines versus manual trephines are presented. Optimal possibilities of examination and storage of donor tissue are explained. A lamellar microkeratome, a...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1045717
更新日期:1992-02-01 00:00:00
abstract:BACKGROUND:The treatment of therapy-resistant secondary glaucoma with cyclodestructive approaches may give rise to unsatisfactory intraocular pressure results, leading to phthisis. A final option may be the implantation of an external glaucoma drainage system (GDS). A consecutive positioning of the drainage system unde...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 临床试验,杂志文章
doi:10.1055/s-2007-963181
更新日期:2007-08-01 00:00:00
abstract::The authors investigated the wound closure of conjunctival wounds with fibrin adhesive as compared to a suture technique in rabbits. Similarly, the fixation of a transplant of lyophilized dura mater on the sclera by fibrin adhesive was also compared with a suture technique. Both clinically and histologically, there we...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1057252
更新日期:1981-07-01 00:00:00
abstract:INTRODUCTION:Until now, venous pressure within the eye has widely been equated with intraocular pressure (IOP). Measurements with dynamometers calibrated in instrument units or in force showed that the retinal venous pressure (RVP) may be higher than the IOP in glaucoma patients. In this study, the RVP was measured wit...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/a-1318-9991
更新日期:2021-01-12 00:00:00
abstract::The central visual fields of 119 glaucomatous eyes (78 patients) were evaluated under controlled conditions using the Goldmann kinetic perimeter and the Fieldmaster-200 automatic supra-threshold computer perimeter. Where there were qualitative differences between the two instruments, the high-resolution program 61 of ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 临床试验,杂志文章
doi:10.1055/s-2008-1057325
更新日期:1981-11-01 00:00:00
abstract:BACKGROUND:Kroll's classification of proliferative diabetic vitreoretinopathy (PDVR) defines stage A (vitreoretinal proliferations without retinal detachment), stage B (partially detached retina not involving the macula), stage C (partially detached macula) and stage D (completely detached macula). The purpose of this ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2002-23500
更新日期:2002-01-01 00:00:00
abstract::Lysosomal storage diseases represent a group of about 50 genetic disorders. The deficiencies of lysosomal and non-lysosomal proteins cause an accumulation of compounds which are normally degraded within the lysosome. There are currently no therapeutic options to cure patients suffering from a lysosomal storage disease...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1109958
更新日期:2011-02-01 00:00:00
abstract::Using the laser flare-cell meter (LFMC), we have previously determined the intensity and pattern of post-ALT ocular inflammation. Inflammation peak occurs 48 hours after ALT and clinically relevant inflammation is seen in 100% of pigmentary glaucomas (PIG), 75% of pseudoexfoliative glaucomas (PEXG) but only in 25% of ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2008-1045765
更新日期:1992-05-01 00:00:00
abstract::A report on 3 instances of accidental injection of lidocaine into the eye. Among the immediate reactions were (1) development of corneal edema due to an abrupt rise in intraocular pressure, (2) dilatation and paralysis of the pupil, (3) decrease of visual acuity to light perception. In 2 of the patients pupillary reac...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1050595
更新日期:1986-02-01 00:00:00
abstract::In 1876 A. Weber introduced chemically from P. jaborandi isolated Pilocarpium muriaticum into the ophthalmological therapy. One year later it was used as a local drug to lower the intraocular pressure in glaucoma and replaced in the following years the extract of Calabar bean (Eserine). Clinical and pharmacological da...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 历史文章,杂志文章
doi:
更新日期:1976-11-01 00:00:00
abstract:INTRODUCTION:Sarcoidosis can manifest itself in a variety of affection patterns in the eye. Early diagnosis and treatment are of crucial importance. Therefore the following three cases present occular symptoms associated with sarcoidosis. METHODS:Three case reports are described. RESULTS:We report three cases with pa...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0032-1328160
更新日期:2013-05-01 00:00:00
abstract::Report on a leiomyoma of the ciliary body in a 12-year-old girl. The clinical findings were misinterpreted as a traumatic ciliary body cyst because of the associated iridodialysis, the fact that the tumor could be transilluminated, because it appeared cystic on ultrasonography, and because there was a history of sever...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1979-12-01 00:00:00
abstract:BACKGROUND:Morbus Morbihan is a rare complication of rosacea, consisting of a persistent lymphoedema of the upper part of the face. It has typically a chronic course, unspecific histopathological findings and an extreme refractoriness to therapy. PATIENTS AND METHODS:Between February 2008 and January 2010, 5 patients ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0029-1245960
更新日期:2011-01-01 00:00:00
abstract::It has been shown by a series of 127 dacryocystorhinostomies using the Toti technique, that this operation, which is independent of age or aethiology, can be performed using a simple procedure and a short hospitalization time. The success rate of over 90% indicates that this operation should be used as a standard proc...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1979-02-01 00:00:00
abstract:BACKGROUND:We describe the clinical findings and course of cilioretinal artery occlusion (CAO) combined with central retinal vein occlusion (CRVO) in two patients and present a review of the relevant literature. HISTORY AND SIGNS:Case 1: An otherwise healthy 24-year-old woman presented to the emergency unit with a pai...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-0029-1245291
更新日期:2010-04-01 00:00:00
abstract::Modern resorbent materials are perhaps still not ideal in every respect. Resorbent fibers are an alternative to the non-resorbent synthetic materials and to Barraquer silk, as the author points out with reference to results of operations carried out during the last three years at the ophthalmological clinic in Aarau. ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1054756
更新日期:1983-03-01 00:00:00
abstract:BACKGROUND:Infections with varicella zoster virus may involve the optic nerve and the retina. Different pathomechanisms have been discussed. We present a case with an autoimmune inflammatory reaction according to the clinical course. PATIENT:A 69-year-old female was referred to our clinic because of suspected bilatera...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1034771
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:MALT Lymphoma of the conjunctiva, eyelid and orbit represents a primary manifestation of the disease in most of the cases. CASE REPORT:A 58-year-old male presented with a tumor in the left inferior eyelid. A full-thickness incisional biopsy was performed. Histopathologically, a lymphoid infiltrate involved ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2000-10398
更新日期:2000-08-01 00:00:00
abstract::In a 36-year-old patient with bilateral Terrien's disease, surgery to improve vision in the right eye, which was in Stage V, was no longer possible. In Stage III a thoroughgoing keratectomy parallel to the limbus was performed, in combination with cataract extraction and coreplasty. Even though Descemet's membrane was...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1054338
更新日期:1985-11-01 00:00:00
abstract::Glaucoma is the leading cause of irreversible blindness in Germany and in the world. Due to the multifactorial genesis of the disease, there are multiple therapeutic approaches for preventing its progression. The goal of the commonly used topical glaucoma medication is to reduce the intraocular pressure and therefore ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/a-1229-1390
更新日期:2020-10-01 00:00:00
abstract::Thirty-one patients with various types of retinopathy were investigated with regard to the effect of anthocyanosides on the retinal vessels. Especially in patients with diabetic retinopathy, a positive influence on the permeability and tendency to hemorrhage was observed. The importance of internal treatment of the pr...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1057228
更新日期:1981-05-01 00:00:00