Effect of the preservation-to-surgery interval on corneal allograft survival in low-risk patients.

BACKGROUND AND OBJECTIVE: To investigate the role of the preservation-to-surgery interval on corneal allograft survival in low-risk patients. PATIENTS AND METHODS: Eighteen donor corneas obtained from an overseas eye bank were preserved and transported overseas in Optisol-GS solution (Chiron Vision, Irvine, CA) in Group 1. Thirty fresh, young, healthy, and unscreened donor corneas soaked in the same medium were used in Group 2. Average preservation-to-surgery time was more than 8 days in Group 1 and less than 30 hours in Group 2. Corneal allograft survival rates were determined by Kaplan-Meier estimates of the survivor functions. The log-rank test was used to determine statistical significance of the differences between groups. was 233.3 +/- 37.7 hours in Group 1 and 20.8 +/- 4.6 hours in Group 2 (P < .05 for the comparison of average times). There were significant differences between the groups with respect to donors' age and enucleation time, but there were no statistically significant differences between the groups in terms of graft diameter and recipient diameter or for corneal allograft survival in low-risk patients. The graft survival rate was 83.3% in Group 1 and 93.3% in Group 2 at the end of the follow-up period. CONCLUSIONS: Preservation-to-surgery time has no effect on corneal allograft survival in low-risk patients. However, prospective, randomized, long-term and large-scale clinical trials are necessary to confirm these findings.     

Translumbar catheter redirection using a tip-deflector technique

A new technique is described for reversing the direction of the catheter tip during translumbar aortography, without the need for partial withdrawal of the catheter from the aortic lumen. The method ensures optimal delivery of contrast medium at the desired level, while avoiding the risk of retroperitoneal bleeding or dislodgement during catheter manipulation.     

Diagnostic value of a psychological test in cases of suspected child abuse

The use of the Bene-Anthony Family Relations Test is described and illustrated by three examples of child abuse. This test should be considered in the investigation of definite or suspected cases of abuse and as part of the preparation of court evidence.     

The comparison of topical ibopamine 2% with tonography to identify the outflow resistance in eyes with ocular hypertension

BACKGROUND: To evaluate the ability of topical ibopamine 2% to detect outflow resistance by comparing it with the tonography test in eyes with ocular hypertension (OHT). METHODS: 62 eyes with OHT and 33 control eyes were included in this prospective study. Tonography was done manually as a standard outflow facility measurement. We used a C value of 0.18 mul/min/mm Hg or less and a P(o)/C value of 100 and above as a positive tonographic test. The ibopamine test performed on the following day was considered positive if there was an intraocular pressure (IOP) change of at least 3 mm Hg. RESULTS: The sensitivity of the tonography and ibopamine tests was 69 and 53%, respectively, in eyes with OHT. The specificity of both tests was 97%. Although the sensitivity of the tonography test is higher than that of the ibopamine test, the difference between both was not statistically significant in these eyes (p = 0.409). Positive results in tonography were associated with higher IOP, while the results were not dependent on the IOP in the ibopamine test. Both tests together were positive in 33.87% (21 eyes) and negative in 11.29% (7 eyes) in 62 eyes with OHT. CONCLUSION: This study revealed that the ibopamine provocation test can detect outflow system resistance in eyes with OHT comparable with tonography which is a traditional outflow facility measurement. Ibopamine, however, can detect the eye with outflow impairment by a different and IOP-independent way, while tonography depends on IOP.     

Correlation between visual function and refractive, topographic, pachymetric and aberrometric data in eyes with keratoconus

AIM: To analyze the relationship between two visual functions and refractive, topographic, pachymetric and aberrometric indicators in eyes with keratoconus. METHODS: Corrected distance visual acuity (CDVA), and letter contrast sensitivity (CS) were correlated with refraction, corneal topography, pachymetry, and total corneal wavefront data prospectively in 71 eyes with keratoconus. The topographic indices assessed were simulated keratometry for the flattest and steepest meridians (SimK1 and SimK2), posterior steeper K (Ks), elevation value in best-fit sphere (BFS) maps, squared eccentricity (?2), aspheric asymmetric index (AAI), pachymetry, thickness progression index (TPI), the amount of pachymetric decentralization (APD), and GalileiTM-keratoconus indices. RESULTS: The mean CDVA (expressed as logMAR) were 0.25±0.21. The mean CS was 1.25±0.46. The spherical refraction correlated well with CDVA (r=-0.526, P<0.001). From topographic indices, SRI correlated with CS (r=-0.695), and IAI with CS (r=-0.672) (P<0.001 for all). Root mean square (RMS) was 4.3±1.81 µm, spherical aberration (SA) was -0.4±0.67 µm, vertical and horizontal coma were -2.1±1.47 and -0.4±0.72 µm. All wavefront data (except horizontal coma), AAI, ?2 and maximum BFS correlated significantly with the visual function (P≤0.001 for all). CONCLUSION: In this study, CS is more affected than CDVA as a visual function. The quantity and quality of vision is significantly correlated with well-known and new topographic indices. There is not a significant correlation between visual function and pachymetric parameters. The significantly correlated indices can be used in staging keratoconus and to follow the outcome of a treatment.