To evaluate indications for paediatric keratoplasty in recipients aged =16 years and assess long-term clinical outcome.
Recipients were identified from records of the Danish Cornea Bank. Data were collected from patient journals, clinical follow-up examinations and questionnaires and stratified into pre-, peri- and postoperative variables. Diagnoses were classified into acquired traumatic, acquired nontraumatic and congenital groups. Recipients were divided into groups of
Department of Ophthalmology & Visual Sciences, Vancouver General Hospital and University of British Columbia, Vancouver, BC. claires@interchange.ubc.ca
The objectives of the present study were: (i) to examine the leading clinical indications and pathologic diagnoses of penetrating keratoplasties in Vancouver, BC; and (ii) to evaluate the correlation between the clinical and pathologic diagnoses.
Retrospective chart review of all pathologic records of corneal tissue submitted to the Department of Pathology & Laboratory Medicine, Vancouver General Hospital, during an 11-year period.
For each penetrating keratoplasty, information regarding the clinical indication and pathologic features identified on histopathologic analysis was compiled.
The top 5 clinical indications for transplant were failed graft (21%); bullous keratopathy (20%); keratoconus (17%); scarring, with or without inflammation (14%); and Fuchs dystrophy (11%). The top 5 pathologic diagnoses corresponded to these clinical diagnoses. In the majority of cases, there was agreement between clinical and pathologic diagnoses; however, in 6% of records, the clinical and pathologic diagnoses did not correlate. This situation occurred most often when considering grafts with clinical diagnoses of bullous keratopathy, Fuchs dystrophy, or keratoconus. A review of the grafts with infectious keratitis illustrated the potential for histopathologic evaluation of corneal buttons to identify unsuspected infectious agents.
Routine histopathologic evaluation of penetrating keratoplasty clarifies the clinical diagnosis in a proportion of cases and aids in identifying infectious agents.
PURPOSE: To establish the age- and gender-specific prevalence of cornea guttata (CG) in citizens of Reykjavik, Iceland, 55 years and older. DESIGN: Cross-sectional, random, population-based study. PARTICIPANTS: The 774 participants were those participating in the second examination of the Reykjavik Eye Study. At baseline, we had a response rate of 75.8%, and at the 5-year follow-up, 88% of the survivors participated. METHODS: We used slit-lamp and non-contact specular microscopy and endothelial specular photography as well as computer-assisted morphometry. We used a standardized grading system for CG. MAIN OUTCOME MEASURES: Diagnosis of primary central CG. RESULTS: The prevalence of CG is 11% for females and 7% for males both for right eyes and left eyes. Higher weight and higher body mass index are found to be associated with decreased risk of CG. Having smoked more than 20 pack-years increased the risk of CG more than 2-fold (P
To examine the prevalence of and risk factors for cornea guttata in a rural southwestern island of Japan.
Cross-sectional, population-based study. All residents of Kumejima Island, Japan, located in southwestern Japan (eastern longitude, 126° 48'; northern latitude, 26° 20'), 40 years or older were asked to undergo a comprehensive questionnaire and ocular examination, including noncontact specular microscopy of corneal endothelial cells. Of the 4632 residents, 3762 (81.2%) underwent the examination. The presence of guttata was determined when round or oval dark areas were observed in the specular microscopy images. Cornea guttata was graded from 0 to 4 depending on the total area of dark spots observed on the specular microscopy images. Diagnosis of primary cornea guttata was the main outcome measure.
Of the 3060 eligible residents, 124 (4.1%; 95% confidence interval, 3.4%-4.8%) had cornea guttata in at least 1 eye. Logistic regression analysis with adjustment for age and/or sex indicated that older age, female sex, and thinner central corneal thickness were associated with an increased risk of cornea guttata.
The prevalence of cornea guttata is 4.1% among residents 40 years or older in Kumejima by specular microscopic criteria only, which is lower than the prevalence reported in the Reykjavik, Iceland, study. A higher prevalence may have been determined if slitlamp biomicroscopy findings had been included. Older age, female sex, and a thinner cornea were independently associated with a higher risk of cornea guttata.
