Dataset Information

Measurement of Gamma-Irradiated Corneal Patch Graft Thickness After Aqueous Drainage Device Surgery.

ABSTRACT:

Importance

Exposure of the tube of an aqueous drainage device (ADD) through the conjunctiva is a serious complication of ADD surgery. Although placement of gamma-irradiated sterile cornea (GISC) as a patch graft over the tube is commonly performed, exposures still occur.

Objectives

To measure GISC patch graft thickness as a function of time after surgery, estimate the rate of graft thinning, and determine risk factors for graft thinning.

Design, setting, and participants

Cross-sectional study of graft thickness using anterior segment optic coherence tomography (AS-OCT) was conducted at the Wilmer Eye Institute at Johns Hopkins Hospital. A total of 107 patients (120 eyes, 120 ADDs) 18 years or older who underwent ADD surgery at Johns Hopkins with GISC patch graft between July 1, 2010, and October 31, 2016, were enrolled.

Intervention

Implantation of ADD with placement of GISC patch graft over the tube.

Main outcomes and measures

Graft thickness vs time after ADD surgery and risk factors for undetectable graft.

Results

Of the 107 patients included in the analysis, the mean (SD) age of the cohort was 64 (16.2) years, 49 (45.8%) were male, and 43 (40.2%) were African American. The mean time of measurement after surgery was 1.7 years (range, 1 day to 6 years). Thinner grafts were observed as the time after surgery lengthened (??regression coefficient, -60 µm per year since surgery; 95% CI, -80 µm to -40 µm). The odds ratio of undetectable grafts per year after ADD surgery was 2.1 (95% CI, 1.5-3.0; P?Conclusions and relevanceGamma-irradiated sterile corneal patch grafts do not always retain their integrity after ADD surgery. Data from this cross-sectional study showed that on average, the longer the time after surgery, the thinner the graft. These findings suggest that placement of a GISC patch graft is no guarantee against tube exposure, and that better strategies are needed for preventing this complication.

SUBMITTER: de Luna RA

PROVIDER: S-EPMC5710544 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Publications

Measurement of Gamma-Irradiated Corneal Patch Graft Thickness After Aqueous Drainage Device Surgery.

de Luna Regina A RA Moledina Ameera A Wang Jiangxia J Jampel Henry D HD

JAMA ophthalmology 20170901 9

<h4>Importance</h4>Exposure of the tube of an aqueous drainage device (ADD) through the conjunctiva is a serious complication of ADD surgery. Although placement of gamma-irradiated sterile cornea (GISC) as a patch graft over the tube is commonly performed, exposures still occur.<h4>Objectives</h4>To measure GISC patch graft thickness as a function of time after surgery, estimate the rate of graft thinning, and determine risk factors for graft thinning.<h4>Design, setting, and participants</h4>Cr ...[more]

PMID: 28772298

Similar Datasets

Project description:Objective:To report long-term clinical outcomes of gamma-irradiated corneal lenticules in partial and full-thickness keratoplasty. Methods and Analysis:This multicentre, retrospective case series includes 23 patients who underwent surgery at three centres (India, Guatemala, and USA) between May 2009 and March 2018. The main outcome measures were epithelialization and retention for therapeutic keratoplasty and best spectacle-corrected visual acuity (BSCVA) for optical keratoplasty. Results:Patients were categorised according to primary aetiology requiring corneal transplantation: non-inflammatory conditions, infectious keratitis and sterile keratolysis. Nine patients with non-inflammatory conditions underwent anterior lamellar keratoplasty (n=7) and Boston type 1 keratoprosthesis (n=2). All nine grafts remained intact and epithelialized during follow-up (median 24 months). In the seven patients who underwent anterior keratoplasty, the graft stayed optically clear during follow-up (median 12 months), with BSCVA between 20/20 and 20/40 in all but one patient who developed cataract. Nine patients with severe infectious keratitis had emergency patch grafting. Six of those grafts epithelialized and remained intact over a median of 30 months, providing tectonic support until optical keratoplasty with fresh tissue could be performed. Three grafts had recurrent infectious keratitis 1-3 months postoperatively, two of which underwent tectonic keratoplasty with fresh tissue which also eventually became infected during follow-up. In five additional patients with sterile keratolysis who underwent lamellar patch graft, two grafts remained intact during follow-up (median 36 months). Two patients had recurrent corneal melt within 1 month, and both had subsequent corneal surgery with fresh tissue which also failed. There were no donor-related complications. Conclusion:Gamma-irradiated sterile corneal stromal lenticules can be considered as a viable alternative to fresh tissue in various clinical settings.

Dataset Information

Measurement of Gamma-Irradiated Corneal Patch Graft Thickness After Aqueous Drainage Device Surgery.

Importance

Objectives

Design, setting, and participants

Intervention

Main outcomes and measures

Results

Publications

Measurement of Gamma-Irradiated Corneal Patch Graft Thickness After Aqueous Drainage Device Surgery.

Similar Datasets

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