Considerations for Corneal Surgery With Patients in the 10th Decade of Life
| Autor: | Steven Gayer, Diego S. Altamirano, Guillermo Amescua, Jaime D. Martinez, Carol L. Karp, Terrence P. O'Brien, Harry Levine, Andrea Naranjo |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Visual acuity genetic structures Keratoprosthesis medicine.medical_treatment Fuchs Endothelial Dystrophy Corneal ulceration Corneal Diseases Cornea Quality of life medicine Humans Local anesthesia Corneal transplantation Retrospective Studies Aged 80 and over Corneal Decompensation business.industry Endothelium Corneal Fuchs' Endothelial Dystrophy Prostheses and Implants eye diseases Surgery Ophthalmology Treatment Outcome Quality of Life Female sense organs medicine.symptom business Descemet Stripping Endothelial Keratoplasty |
| Zdroj: | Cornea. 41:1222-1231 |
| ISSN: | 0277-3740 |
| Popis: | PURPOSE The purpose of this study was to report the indications, ocular and systemic comorbidities, and surgical outcomes of corneal transplantation in patients older than 90 years. METHODS A retrospective review was conducted to identify individuals 90 years and older who underwent corneal transplantation surgery at the Bascom Palmer Eye Institute between January 2013 and October 2020. Outcomes included best-corrected visual acuity and graft survival over time. Paired t tests were used to compare visual acuity preoperatively versus postoperatively. Graft survival was evaluated with Kaplan-Meier curves. RESULTS Fifty-eight eyes of 52 consecutive individuals were included. The mean age of individuals was 92 ± 2 years; 26.9% were male; and 48.1% self-identified as non-Hispanic White and 38.5% as Hispanic. Postoperative follow-up was 14.7 ± 12.1 months. Of the 58 eyes, 44.8% (26/58) underwent penetrating keratoplasty, 46.6% (27/58) Descemet stripping automated endothelial keratoplasty, and 6.9% (4/58) keratoprosthesis. All surgeries were performed under monitored local anesthesia, without major complications. Surgical indications included pseudophakic bullous keratopathy (36.2%), glaucoma-associated corneal decompensation (27.6%), Fuchs endothelial dystrophy (25.9%), and perforated corneal ulceration (19.0%). The best-corrected visual acuity improved by 0.32 (95% confidence interval 0.14-0.50; P < 0.01) as early as 1 month postoperatively, and vision gains were sustained for at least 12 months. Graft survival probability at 12 months was 88%. CONCLUSIONS Corneal transplantation is a safe and successful procedure in restoring the visual acuity for patients older than 90 years after careful preoperative evaluation. Further research is needed to evaluate the impact of corneal transplantation on quality of life in patients in the 10th decade of life. |
| Databáze: | OpenAIRE |
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