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Purpose
To compare the effectiveness of femtosecond laser (FSL) assisted and manual arcuate keratotomy (AK) procedures for the correction of postkeratoplasty astigmatism.Methods
Fifty-two eyes (52 patients) were treated with FSL assisted AK and 53 eyes (51 patients) with manual AK for post-keratoplasty astigmatism. The main outcome measures included preoperative and postoperative manifest refraction, uncorrected and corrected distance visual acuity (UDVA, CDVA), corneal topography and complications.Results
In FSL group, UDVA changed significantly from 0.90?±?0.43 preoperatively to 0.60?±?0.39 at last follow-up (p?=?0.001). In manual group, preop- (0.87?±?0.35) and post-operative UDVA (0.93?±?042) were comparable (p?=?0.535). CDVA improved from 0.30?±?0.18 preoperatively to 0.20?±?0.14 at last follow-up visit in FSL group (0.014) and 0.28?±?0.15 preoperative to 0.23?±?0.19 at last postoperative visit (0.074) in manual group. Postoperative UDVA and CDVA were comparable between both the groups (p?>?0.05). The mean preoperative refractive cylinder was 6.38?±?3.73 and 7.15?±?132, decreasing significantly to 5.06?±?2.06 and 5.19?±?2.25 after manual and FSL assisted AK procedures respectively. Mean change in the refractive cylinder was ?1.10?±?4.11 in manual AK group and ?2.19?±?2.35 in FSL group (p?=?0.134). Perforation, overcorrection and regression occurred in respectively 3 eyes (5.8%), 12 eyes (23.07%) and 1 eye (1.92%) in FSL group and 1 eye (1.9%; macro-perforation), 7 eyes (13.21%) and 8 eyes (15.09%) in manual group. Additionally, in the manual group, severe ectasia occurred in 1 eye (1.9%).Conclusion
FSL assisted AK procedure is comparable or to a certain extent better regarding safety and efficacy than manual AK procedure. Postoperatively, FSL resulted in better outcomes of UCVA, BCVA, refractive cylinder and keratometric astigmatism compared to the manual AK procedures; although, the difference between the groups was not statistically significant. 相似文献114.
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Shrinkage and whitening of the anterior capsule opening – capsular contraction syndrome – is a well-known complication after continuous curvilinear capsulorrhexis.A 72-year-old women underwent continuous curvilinear capsulorrhexis, phacoemulsification, and implantation of posterior chamber intraocular lens with polymethylmethacrylate haptics. Four months postoperatively, the patient reported deterioration in visual acuity that was resulted due to complete occlusion of anterior capsular opening by fibrotic tissue. The fibrous membrane was excised surgically in capsulorrhexis fashion. 相似文献
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J. Martinelli D. Habes L. Majed C. Guettier E. Gonzalès A. Linglart C. Larue V. Furlan D. Pariente C. Baujard S. Branchereau F. Gauthier E. Jacquemin O. Bernard 《American journal of transplantation》2018,18(7):1680-1689
We report the results of a study of survival, liver and kidney functions, and growth with a median follow‐up of 24 years following liver transplantation in childhood. From 1988 to 1993, 128 children underwent deceased donor liver transplantation (median age: 2.5 years). Twenty‐year patient and graft survival rates were 79% and 64%, respectively. Raised serum aminotransferase and/or γ‐glutamyl transferase activities were present in 42% of survivors after a single transplantation. Graft histology (35 patients) showed signs of chronic rejection in 11 and biliary obstruction in 5. Mean total fibrosis scores were 4.5/9 and 3/9 in patients with abnormal and normal serum liver tests, respectively. Glomerular filtration rate was <90 mL·min?1 in 35 survivors, including 4 in end‐stage renal disease who were undergoing dialysis or had undergone renal transplantation. Median final heights were 159 cm for women and 172 cm for men; final height was below the target height in 37 patients. Twenty‐year survival after childhood liver transplantation may be close to 80%, and final height is within the normal range for most patients. However, chronic kidney disease or altered liver biochemistries are present in over one third of patients, which is a matter of concern for the future. 相似文献
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Adham Elsayed Sebastian Wille Majed Al-Akhali Matthias Kern 《The Journal of prosthetic dentistry》2017,117(4):499-506