12-Jahres-Resultate nach mikrokeratomassistierter anteriorer lamellierender therapeutischer Keratoplastik (ALTK) für Erkrankungen des anterioren Hornhautstromas – Vergleich von Erwachsenen und Kindern [12-Year Outcomes of Microkeratome-Assisted Anterior Lamellar Therapeutic Keratoplasty (ALTK) for Disorders of the Anterior Part of the Corneal Stroma - A Comparative Review of Adult and Children]

Détails

ID Serval
serval:BIB_364A5972F9B5
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
12-Jahres-Resultate nach mikrokeratomassistierter anteriorer lamellierender therapeutischer Keratoplastik (ALTK) für Erkrankungen des anterioren Hornhautstromas – Vergleich von Erwachsenen und Kindern [12-Year Outcomes of Microkeratome-Assisted Anterior Lamellar Therapeutic Keratoplasty (ALTK) for Disorders of the Anterior Part of the Corneal Stroma - A Comparative Review of Adult and Children]
Périodique
Klinische Monatsblatter fur Augenheilkunde
Auteur(s)
Guber I., Bergin C., Othenin-Girard P., Munier F., Majo F.
ISSN
1439-3999 (Electronic)
ISSN-L
0023-2165
Statut éditorial
Publié
Date de publication
04/2018
Peer-reviewed
Oui
Volume
235
Numéro
4
Pages
404-408
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Résumé
To report the visual outcomes and complications of automated anterior lamellar therapeutic keratoplasty (ALTK) in adults and children, and to examine these outcomes as a function of age and etiology.
A consecutive series of cases undergoing automated ALTK procedures performed at the Jules-Gonin Eye Hospital Lausanne, Switzerland, between June 2003 and January 2015. Only patients with at least 3 months of follow-up were included.
There were 53 eyes (24 right) of 51 patients (17 female, 16 juvenile), with a mean age of 34.8 years (range from 3 months to 88 years), analyzed. The mean follow-up was 35 (± 26) months. Diagnosis in the adult (n = 37) vs. juvenile (n = 16) eyes was different: opacity following surgical complication 8 vs. 0, congenital 1 vs. 1, dystrophy 5 vs. 2, infection 12 vs. 5, keratectasia 3 vs. 0, trauma 7 vs. 0, tumor 1 vs. 3, and allergy 0 vs. 5. Visual impairment as a consequence of corneal scarring was the principle indication for surgery in both adult (70%; 26) and juvenile eyes (63%; 10); other indications were choristoma, dermoid, other tumors, astigmatism, and congenital opacity. In adult vs. juvenile eyes, the mean visual acuity (spectacle and contact lenses) was, at last visit, 0.55 vs. 0.45 LogMAR (p = 0.78), with a range of 100% to hand movements. Failure occurred in 6 (16%) vs. 2 (13%) cases and complications were observed in 14 (38%) vs. 9 (56%) cases, however, more surgical revision was required in juvenile eyes, 4 (11%) vs. 7 (43%) (p = 0.01, Fisher test).
This study shows that anterior lamellar keratoplasty in children retains good visual function when combined with adequate amblyopic therapy. However, the rate of complications is higher in juveniles and requires more intensive interdisciplinary follow-up.
Mots-clé
Adolescent, Adult, Aged, Aged, 80 and over, Astigmatism/etiology, Child, Child, Preschool, Corneal Opacity/surgery, Corneal Stroma/surgery, Corneal Transplantation/instrumentation, Corneal Transplantation/methods, Female, Follow-Up Studies, Humans, Infant, Male, Middle Aged, Outcome and Process Assessment (Health Care), Postoperative Complications/etiology, Refraction, Ocular, Retrospective Studies, Visual Acuity, Young Adult
Pubmed
Web of science
Création de la notice
19/04/2018 16:33
Dernière modification de la notice
20/08/2019 13:24
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