Biomedical subjects

Olivier Touzeau

Publications and source records attributed to Olivier Touzeau.

5 recordsLinked to original sources

PubMed2006

Graft reepithelialization after penetrating keratoplasty using organ-cultured donor tissue.

OBJECTIVE: To analyze graft reepithelialization after penetrating keratoplasty using organ-cultured donor tissue. DESIGN: Retrospective observational cohort study. PARTICIPANTS: One thousand one hundred thirty-eight consecutive penetrating keratoplasties (1003 patients) performed between 1992 and 2004 were analyzed, and 1003 were included (1 graft per patient was included). METHODS: Slit-lamp examination after fluorescein staining. MAIN OUTCOME MEASURE: Graft reepithelialization time was recorded. RESULTS: The average graft reepithelialization time was 4.6+/-13.2 days (range, 1-210 days; median, 2.5 days). Complete corneal epithelial healing was obtained in 1 day in 28.5% of patients, in 3 days in 65.8%, in 7 days in 93.6%, and in 14 days in 97.0%. Postoperative chronic epithelial defects occurred in 3.0% of patients. In univariate analysis, death-to-storage time, storage time, deswelling time, rejection risk, trephination size, suture method, use of dexamethasone ointment during surgery, use of sodium hyaluronate during surgery, and use of high postoperative steroid regimen significantly influenced the graft reepithelialization time (P<0.05). In multiple regression, only the rejection risk (beta = 0.07; P = 0.045), use of sodium hyaluronate at the end of surgery (beta = -0.17; P = 0.001), and steroid regimen (beta = 0.09; P = 0.022) significantly influenced the graft reepithelialization time. CONCLUSIONS: The use of sodium hyaluronate at the end of surgery to coat the ocular surface shortened graft reepithelialization time after penetrating keratoplasty using organ-cultured donor tissue. Graft reepithelialization time was longer in high-risk recipients, and it increased with high dexamethasone eyedrops regimen.

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PubMed2006

Late changes in refraction, pachymetry, visual acuity, and corneal topography after penetrating keratoplasty.

PURPOSE: To analyze the late changes in refraction, corneal topography, and pachymetry after penetrating keratoplasty. METHODS: We have retrospectively analyzed data of 64 eyes of 56 patients with a clear corneal graft and no other ocular diseases. The eyes were examined soon and several years after all sutures were removed, at 19.5 +/- 3.1 months and 76.8 +/- 25.2 months, respectively, after keratoplasty. All eyes were examined using the EyeSys 2000 videokeratograph and the Tomey SP2000 ultrasonic pachymeter. Corneal surface regularity was studied using the indices provided by the Holladay Diagnostic Summary (ie, asphericity coefficient Q; corneal uniformity index CU; predicted corneal acuity PCA). Irregular astigmatism was quantified using semimeridian data from videokeratographs (refractive power symmetry index). RESULTS: Visual acuity increased by an average of 0.35 +/- 0.93 lines (P = 0.002) between the 2 examinations, whereas no significant changes in refraction and videokeratoscopy (ie, power, indices, and irregular astigmatism) were observed (P > or = 0.08). Central corneal thickness significantly increased from 542 +/- 31 microm to 572 +/- 38 microm (P < 0.001). Change in BSCVA did not significantly correlate with the change in refraction, in topographic indices, or in irregular astigmatism (rs < or = 0.13; P > or = 0.16). CONCLUSION: Late after penetrating keratoplasty, best corrected visual acuity shows a small but statistically significant improvement, whereas refraction and corneal surface regularity are stable. This late improvement in visual acuity is not explained by current techniques.

Adolescent↗

PubMed2005

Outcome of graft central thickness after penetrating keratoplasty.

OBJECTIVE: To analyze the outcome of graft central thickness after penetrating keratoplasty. DESIGN: Retrospective observational cohort study. PARTICIPANTS: Eight hundred fifty-six consecutive penetrating keratoplasties (772 patients) performed between 1992 and 2001 were analyzed and 772 were included (1 graft per patient was included). METHODS: Slit-lamp examination and ultrasound pachymetry. MAIN OUTCOME MEASURES: Slit-lamp findings, intraocular pressure, and graft central thickness were recorded. RESULTS: Patients were observed for an average of 55 months. The 36- and 60-month graft survival estimates were, respectively, 77.2% and 71.0%. The average graft central thickness in successful transplants was 655 microm at 1 week, 558 microm at 1 month, 533 microm at 6 months, 538 microm at 12 months, 558 microm at 24 months, 561 microm at 36 months, and 568 microm at 5 years. At each postoperative time point, the percentage of eyes with decreased, normal, and increased graft central thickness was significantly different according to slit-lamp findings. Of the patients with increased graft thickness, 46.2% had a simple outcome (normal intraocular pressure and normal slit-lamp findings), 28.6% experienced rejection, 15.8% experienced a graft nonimmunological event, and 9.4% experienced increased intraocular pressure. At each postoperative follow-up, subsequent graft survival was significantly lower in patients with increased graft thickness as compared with patients with normal or decreased graft thickness. When analyzing only patients with simple outcome, the relative risk of graft failure was 3.3 if graft thickness was increased at 1 month (P<0.0001). CONCLUSIONS: In conclusion, graft central thickness assessed by ultrasound pachymetry is a useful method for observing patients who have undergone penetrating keratoplasty. Even when slit-lamp examination reveals no complications, patients with an increase in graft thickness above the upper limit of normal for the postoperative time point under consideration are at greater risk of failure.

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PubMed2004

Culture-proven herpetic keratitis after penetrating keratoplasty in patients with no previous history of herpes disease.

OBJECTIVE: To report three cases of herpetic infection in recipients of organ-cultured donor corneas among 586 consecutive corneal transplantation procedures. METHODS: Three patients with no history of symptomatic herpes infection underwent corneal transplantation for keratoconus (2 patients) and Fuchs dystrophy (1 patient). Two patients developed keratouveitis and primary graft failure. The third patient developed dendritic keratitis in the graft. Culture of corneal scrapings and the patient's bandage contact lens were positive for herpes simplex virus type 1 (HSV-1). Donor and recipient sera were tested for HSV serology by EIA. Recipient corneal buttons were studied by means of transmission electron microscopy and immunohistochemistry. The three HSV-1 strains were genotyped by sequencing part of a variable antigenic domain of glycoprotein B (gB). RESULTS: None of the donor corneas showed endothelial cell necrosis after organ culture. All keratoplasties performed with the three mate donor corneas had an uncomplicated course. All three donor sera were positive for HSV. Preoperative recipient sera were positive for HSV. Analysis of the recipient corneal buttons showed no evidence of herpetic infection. Sequence analysis revealed three different gB genotypes. CONCLUSION: Ascertaining that a postoperative herpetic infection in a corneal transplant originates from the donor tissue is still difficult. Although some features of the reported cases suggest donor-to-host transmission of herpes simplex virus, the recipients could have been the source of the virus.

Adult↗

PubMed2003

Candida parapsilosis keratitis.

PURPOSE: To present clinical, microbiologic, and histopathologic features of keratitis due to Candida parapsilosis. METHODS: Clinicomicrobiologic evaluation of four patients (four eyes) with culture-proven C. parapsilosis keratitis. The patients were evaluated for symptoms, visual acuity, clinical observations, microbiologic examination of corneal scrapings, and pathologic examination of corneal buttons. RESULTS: Three cases were observed after penetrating keratoplasty, and one case occurred after inhalation of corticosteroids. Clinical presentation of C. parapsilosis keratitis showed a great diversity. There was one case of crystalline keratopathy and three cases of suppurative corneal infiltrate. Histopathology of corneal buttons showed interlamellar accumulations of yeast. Medical treatment included topical amphotericin B and systemic triazoles. Penetrating keratoplasty was required in three patients. CONCLUSION: Risk factors for C. parapsilosis keratitis may include corticosteroid use and prior corneal transplantation. The prognosis of C. parapsilosis keratitis with antifungal and surgical therapy may vary from good visual outcome to intraocular extension with phthisis bulbi.

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