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Biomedical subjects

N Granet

Publications and source records attributed to N Granet.

6 recordsLinked to original sources

Epikeratophakia: the surgical correction of aphakia. Update: 1982.

Sixty-five epikeratophakia procedures have been performed in 63 patients; visual acuity data have been tabulated on 31 patients with 4 to 30 months follow-up. Patients with more than a year of follow-up showed stable keratometry readings. Early patients achieved 70% of the predicted dioptric correction; more recent patients have achieved 87% with improvements in the lathing procedure, tissue handling, and surgical technique. Visual acuities improve with time. At any given time after surgery, acuities measured with a hard contact lens are better than those measured with spectacles; the decrease in spectacle acuity is probably a result of irregular refraction at the graft surface. The gap between contact lens and spectacle acuity decreases with time. A number of patients achieve postoperative visual acuities better than their preoperative acuities, and most achieve final spectacle acuities within a line or two of their preoperative acuities.

Aphakia, Postcataract↗

Update on keratophakia.

Visual results are reported for 23 cases of keratophakia for the correction of surgical aphakia followed from 12 to 48 months. Seventeen of the 23 patients had final visual acuities of 20/40 or better. The average residual visual overrefraction was 1.87 +/- 1.79 diopters (mean +/- SE), with an increase of postoperative astigmatism of 1.70 +/- 1.33 diopters. Complications included interface deposits and peripheral epithelial deposits that did not interfere with vision. One patient had an anterior chamber penetration and subsequent penetrating keratoplasty, and two patients had lenticules removed because of corneal edema secondary to increased intraocular pressure. The major disadvantages of keratophakia are the complexity of the procedure and the time required (4 to 6 months) to achieve best-corrected spectacle visual acuity. However, because this procedure is extraocular, it is a better choice than secondary intraocular lens implantation for patients who are unilaterally aphakic and for the young patient.

Aphakia, Postcataract↗

Keratocyte survival in keratophakia lenticules.

Keratocyte survival in corneal lenticules preparing by cryolathing was evaluated using the vital stain, nitroblue tetrazolium. A comparison was made between lenticules inserted in the recipient cornea immediately after grinding and those inserted after one week of storage in either glycerin or liquid nitrogen. In all three groups, no viable keratocytes stained in the donor lenticule at one or three days after surgery. Ten days after insertion, however, all three groups showed a few staining cells within the body of the lenticule, suggesting beginning repopulation of the donor collagenous framework with viable cells from the host. Since the donor keratocytes are dead, healing of keratophakia lenticules is not influenced adversely by storing the donor material. Thus, keratophakia lenticules could be prepared in advance of surgery and stored in glycerin or liquid nitrogen until needed.

Animals↗

Epikeratophakia: the surgical correction of aphakia. III. Preliminary results of a prospective clinical trial.

Epikeratophakia is a newly developed, investigational form of refractive corneal surgery for the correction of aphakic vision. The procedure involves the removal of the corneal epithelium from the recipient eye and the suturing of a prelathed lamellar donor corneal graft onto the surface of the recipient cornea. We initiated a prospective clinical trial of epikeratophakia in comparison with keratomileusis; however, only 14 patients were randomized between the two procedures, after which the protocol was modified to eliminate the keratomileusis procedure. subsequently, all patients who entered into the study underwent epikeratophakia. The limited comparative study showed that epikeratophakia was at least as effective as keratomileusis in terms of visual potential and visual recovery. The major problem encountered was undercorrection, which was largely eliminated by the use of donor tissue larger in diamter than the recipient bed. Three months postoperatively, five of seven patients undergoing epikeratophakia had 20/50 or better visual acuity with spectacle overcorrection.

Adolescent↗

Keratophakia using preserved lenticules.

Using cats as an experimental model, we compared the clarity of fresh, glycerine-preserved and nitrogen-preserved lenticules (corneal stromal implants) in keratophakia. No difference in final clarity was observed and the change in corneal curvature was maintained. In six patients freshly cut lenticules were used; in nine patients liquid nitrogen-preserved lenticules were used. Again, no difference in final clarity or correction was noted. The use of preserved, precut tissue in keratophakia will make this technique available to the general ophthalmic surgeon.

Animals↗

Corneal steepening in human eye bank eyes by combined hexagonal and transverse keratotomy.

An interrupted 5 mm diameter hexagonal keratotomy was modified to include six paracentral transverse incisions to augment the central corneal steepening. This combined modified-hexagonal and transverse (or hexagonal-transverse) keratotomy was performed on human eye bank eyes to an estimated 85% corneal depth yielding a mean of 7.50 +/- 1.69 diopter increase in central keratometric power (P less than .001); this finding was confirmed by keratography. These results encourage further studies of this procedure and its potential to surgically correct mild amounts of hyperopia.

Analog-Digital Conversion↗