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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The indications for penetrating keratoplasty have changed over the past several years. One hundred and eighty cases of penetrating keratoplasty performed in the Department of Ophthalmology, Naestved Centralsygehus, Denmark, from January 1984 to December 1993, were analysed. Overall pseudophakic bullous keratopathy was the most common indication for penetrating keratoplasty (28.3%). This was followed by keratitis (13.9%), Fuchs' dystrophy (13.9%), regraft (11.1%), aphakic bullous keratopathy (10.0%) and keratoconus (6.7%). Pseudophakic bullous keratopathy was the most common indication for penetrating keratoplasty in 1989 and in each year from 1991 to 1993. Before 1989 the most common indications were keratitis (18.0%) and aphakic bullous keratopathy (14.8%). The emergence of pseudophakic bullous keratopathy, as the most common indication for penetrating keratoplasty, correlates well with the dramatic increase in the number of cataract extractions with intraocular lens implantation performed since the early 1980s. Especially semiflexible, closed-loop anterior chamber lenses used in our department in the early years of the period, have been the cause of subsequent corneal edema.
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PMID:Changing indications for penetrating keratoplasty. 782 9

Four hundred and sixteen penetrating keratoplasties performed at St John Ophthalmic Hospital, Jerusalem, between January 1988 and July 1992 were reviewed retrospectively. The leading indications were keratoconus, microbial keratitis, trachomatous corneal scarring and herpes simplex keratitis. After a mean follow-up of 12.4 months (> 1-48 months) 79.8% of the grafts remained clear. The results in terms of graft clarity and visual improvement varied among the different diagnostic groups. No relationship was found between donor age, cadaver time or storage time and graft survival. This series demonstrates the viability of penetrating keratoplasty in this area of low economic development but highlights the need for strict patient selection to ensure optimal use of scarce donor material.
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PMID:Penetrating keratoplasty in the West Bank and Gaza. 801 15

Crouzon's syndrome is an autosomal dominant disorder characterized by premature craniosynostosis leading to multiple ocular abnormalities and vision loss. Strabismus, optic atrophy, exposure keratitis, hypertelorism, nystagmus, and unexplained visual loss have been reported. Keratoconus has been described only once previously in a patient with other ocular abnormalities. This article reports bilateral keratoconus in a patient with Crouzon's syndrome without other ocular pathology. We emphasize the importance of early recognition and therapy of this treatable cause of decreased vision in Crouzon's syndrome.
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PMID:Bilateral keratoconus in Crouzon's syndrome. 813 12

We report a retrospective analysis of the clinical indications for 3555 penetrating keratoplasties performed at our department between 1971 and 1990. The cases were distributed among 12 diagnostic categories. Regrafting was the most common indication overall, accounting for 1452 cases (40.8%). Other major indications were, in order of decreasing frequency, keratoconus (17%), scarring secondary to herpes simplex keratitis (11.7%), aphakic bullous keratopathy (5.9%) and interstitial keratitis (5%). Further analysis of the relative percentages in each category within each 5-year interval of the study period was carried out to identify any changes in incidence. Viral disease as an indication for penetrating keratoplasty has shown a gradual decrease in frequency, accounting for only 6.4% of the cases during the last 5-year period (1986-90) compared with 19.6% during the first 5 years (1971-75). This finding is consistent with the marked improvement in the recognition and medical treatment of herpes simplex keratitis. The increase in incidence of grafting for pseudophakic bullous keratopathy in 1986-90 (6.7%) compared with 1981-85 (1.1%) correlates well with the dramatic increase in the number of cataract extractions with intraocular lens implantations performed during that period.
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PMID:Changing indications for penetrating keratoplasty, 1971-1990. 825 25

We observed 6 cases of secondary keratoconus with Fleischer's ring pattern corneal epithelial iron ring. These 6 cases were 2 males and 4 females. The causes of secondary keratoconus were 2 cases of trachoma, 2 cases of trauma, 1 case of keratitis, and 1 case of unknown origin. All showed thinning of the cornea and Fleischer's ring pattern corneal epithelial iron ring. After penetrating keratoplasty of 1 case, the button of the recipient showed the deposition of hemosiderin in the corneal epithelium stained blue by Prussian blue. At the same time we confirmed the existence of iron in the corneal epithelium by the X-ray ultimate analysis. Fleischer's ring is considered to be characteristic of keratoconus, but we have found that Fleischer's ring is also seen in secondary keratoconus in which the cornea becomes thinner secondarily for some reason.
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PMID:[Six cases of secondary keratoconus with Fleischer's ring pattern corneal epithelial iron ring]. 864 46

Lyme disease is a multisystem disorder caused by infection with the Borrelia burgdorferi spirochete. The diagnosis of Lyme disease usually is based on several clinical criteria, with supportive data from laboratory testing. The presence of the bullseye skin lesion, erythema migrans, is the single pathognomonic criterion. In the 20 years since the initial description of Lyme disease in the United States, B. burgdorferi has been implicated as an etiologic agent in numerous ophthalmic and neuro-ophthalmic syndromes, involving most structures from the cornea to the cranial nerves. Neuro-ophthalmic and ocular manifestations of Lyme disease include meningitis with papilledema, cranial neuropathies, follicular conjunctivitis, nummular keratitis, and intraocular inflammation. Although an association with Lyme disease has been purported for numerous other syndromes, a definite causal relationship has not been proved in many cases. During a period of rapidly increasing awareness of Lyme disease, a high index of suspicion and poorly defined criteria for its presence have resulted in over-diagnosis of Lyme disease. In the authors' experience, the incorrect diagnosis of Lyme disease initially has been made in patients with allergic conjunctivitis, keratoconus, morning glory syndrome, craniopharyngioma, meningioma, CNS lymphoma, paraneoplastic syndrome, multiple sclerosis, sarcoid, syphilis, and functional illness. Nevertheless, this treatable infection must be an important consideration in the differential diagnosis of certain ocular or neurologic diseases.
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PMID:Neuro-ophthalmic manifestations of Lyme disease. 917 82

We analyzed all penetrating keratoplasties performed in the Singapore National Eye Centre from 1 January 1991 to 31 December 1995, using records of the Singapore Eye Bank Registry, evaluating the indications, complications, causes of graft failure, visual outcome and graft survival rate. We also looked into donor cornea acquisition in the Singapore Eye Bank and its influence on the development of corneal transplantation in the Singapore National Eye Centre. A total of 327 penetrating keratoplasties were performed during the 5-year period. Bullous keratopathy was an indication in 26.3% of cases. Of these, aphakic bullous keratopathy accounted for 11.6% of all cases, while pseudophakic bullous keratopathy accounted for 11.3%. Other indications were regrafts (11.9%), corneal dystrophies (10.4%), traumatic corneal scarring (10.1%) and keratoconus (9.8%). Graft rejection was a complication in 20% of all cases. Of these, 40.9% led to graft failure. Other major complications were raised intraocular pressure (18%), epithelium-related problems (7.3%), wound dehiscence (4.3%), cataract (3.3%) and microbial keratitis (3.1%). The main causes of graft failure were graft rejection (8.2%), endothelial failure (2.4%), infection (2.4%) and glaucoma (2.1%). Of the 327 grafts, 40.3% achieved best corrected visual acuity of 6/12 or better; 70.8% achieved vision of 6/24 or better. The overall graft survival rate was 82.3% after a mean follow-up period of 2 years. Donor corneas for the penetrating keratoplasties were obtained from foreign eye banks as well as locally, with the local donation rate steadily increasing from 1991 to 1996, with the establishment of proper eye banking facilities and the Singapore Eye Bank. These results show that the indications and outcome of penetrating keratoplasty in the Singapore National Eye Centre are similar and comparable to that of other centres with established corneal grafting programmes. The establishment of the Singapore Eye Bank has ensured the proper co-ordination of acquisition of donor material which has been vital to the development of corneal transplantation in the Singapore National Eye Centre.
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PMID:Penetrating keratoplasty in the Singapore National Eye Centre and donor cornea acquisition in the Singapore Eye Bank. 939 97

Indications for penetrating keratoplasty (PK) in the developing world from a large series are not well documented. This study was done to evaluate the indications for PK in a major eye care institution in India. The records for a consecutive series of 1,964 PKs were analysed and multiple logistic regression was used to study the effect of age, socioeconomic status and sex on the indications for PK. The indications for PK were corneal scarring in 551 (28.1%) including adherent leukoma in 147 (7.5%), regrafts in 336 (17.1%), active infectious keratitis in 239 (12.2%), aphakic bullous keratopathy in 231 (11.8%), pseudophakic bullous keratopathy in 209 (10.6%), corneal dystrophies in 165 (8.4%) including Fuchs' dystrophy in 23 (1.2%), keratoconus in 118 (6%), and miscellaneous in 115 (5.9%). The odds that the patient belonged to lower socioeconomic status were significantly higher if the PK was done for active infectious keratitis (odds ratio 2.73, p < 0.0001), corneal scarring (odds ratio 1.72, p = 0.0009) or regraft (odds ratio 1.44, p = 0.047). Corneal scarring, including adherent leukoma, and active infectious keratitis are relatively more common indications whereas keratoconus, pseudophakic bullous keratopathy and Fuchs' dystrophy are less common indications for PK in India than reported from the developed world. Indications for PK which carry a poorer prognosis for graft survival are relatively more common in India than in the developed world.
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PMID:Indications for penetrating keratoplasty in India. 947 18

Down syndrome (DS) is the most common cause of mental retardation in North America, yet little information is available on the natural history of DS in adults. We report on significant medical problems of adults with DS (DS adults) residing in a British Columbia provincial residential center, Woodlands, over the 12-year period from 1981 through 1992. Prospective, yearly health care reviews on 38 DS adults are summarized according to age. Group 1 consists of 18 middle-aged DS adults less than 50 years old, and group 2 comprises 20 elderly DS adults 50 years and older. Significant health problems in all DS adults include untreated congenital heart anomalies (15. 8%), acquired cardiac disease (15.8%), pulmonary hypertension (7.8%), recurrent respiratory infections/aspiration leading to chronic pulmonary interstitial changes (30%), complications from presenile dementia/Alzheimer-type disease (42%), adult-onset epilepsy (36.8%), osteoarthritic degeneration of the spine (31.6%), osteoporosis with resultant fractures of the long bones (55%) or vertebral bodies (30%), and untreated atlantooccipital instability (7.9%). Acquired sensory deficits are significant problems including loss of vision due to early onset of adult cataracts (50%), recurrent keratitis (21%) or keratoconus (15.8%), and significant hearing loss (25%). Behavioral problems (50%), loss of cognitive abilities, and onset of symptoms of Alzheimer disease (group 1: 5.5%; group 2: 75%) pose ongoing challenges for care. In conclusion, the quality of life for adults with DS can be improved by routine, systematic health care screening to identify treatable diseases that may be missed because of poor communication or confusion due to Alzheimer disease.
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PMID:Health care concerns and guidelines for adults with Down syndrome. 1055 65

The first successful corneal transplantation was done in 1906, when the corneas of a recently deceased boy were transferred to a man blinded by an alkali burn. Since then, improved equipment, microsurgical technique and better methods for treating postoperative complications have greatly improved the prognosis of corneal grafting. Immunological reactions are less frequently seen after keratoplasty than after other types of transplantation, and the graft is also directly accessible for immunosuppressive treatment. Penetrating keratoplasty accounts for more than 95% of all corneal transplantations in Norway, the other procedures being lamellar grafting and epikeratophakia. While keratitis and macula corneae previously were the main indications for keratoplasty, keratoconus is at present the most frequent indication. The prognosis is poorer in eyes with extensive vascularization, lacking sensibility, insufficient tear secretion and marked symblepharon. Due to shortage of suitable donor tissue, the waiting lists for this type of ocular surgery are increasing.
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PMID:[Corneal transplantation]. 1066 85


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