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PubMed · 1757052

[Double-guided vacuum trephine system "Asmotom"].

H Bull·S Deutschmann·H W Schlote
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Abstract

A new, doubly guided cornea suction trephine system is presented. By means of a suction rim placed on the limbus corneal and a suction disc in the centre of the cornea the vault of the cornea is preserved throughout the trephination procedure. Cutting is performed by a motor trephine, which rotates between the inner and the outer suction. The system allows creation of an absolutely safe perforation in a 360 degrees cut. The cut edges are precise and sharp. Both donor and recipient are trephined from the epithelial side. The endothelial cell loss is very low, amounting to 0.170 mm. The suction stabilization prevents any tilting of the trephine and avoids elliptical forms. Preliminary clinical experiences are presented.

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Corneal TransplantationEndothelium, CornealHumansKeratoplasty, PenetratingSuctionEnglish AbstractJournal Article

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BibTeXRIS

H Bull, S Deutschmann, H W Schlote. 1991. [Double-guided vacuum trephine system "Asmotom"].. https://pubmed.ncbi.nlm.nih.gov/1757052/

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PubMed2006

How effective is penetrating corneal transplantation? Factors influencing long-term outcome in multivariate analysis.

BACKGROUND: In a large patient cohort, we investigated long-term corneal graft outcome, risk factors for graft failure, and whether corneal graft survival had improved over time. METHODS: Records of 10,952 full-thickness corneal grafts with associated archival follow-up were examined within a prospectively-maintained, national database of 13,831 records, with follow-up extending for up to 18 years. Kaplan-Meier survival analysis was used to indicate variables of interest for Cox proportional hazards regression analysis. A model clustered by individual patient to control for inter-eye or inter-graft dependence was constructed to identify variables best predicting penetrating corneal graft failure. RESULTS: Probability of corneal graft survival was 0.86 at 1 year, 0.73 at 5 years, 0.62 at 10 years, and 0.55 at 15 years. Graft survival did not improve over a 15-year timeframe. Variables predicting graft failure in multivariate analysis included transplant centre, donor age, preoperative diagnosis, number of previous ipsilateral grafts, lens status, history of corneal neovascularisation, ocular inflammation or raised intraocular pressure in the grafted eye, requirement for anterior vitrectomy, graft size, early suture removal, postoperative events including graft neovascularisation, rise in intraocular pressure, and rejection episodes, type of treatment for raised intraocular pressure, and arrangements for recipient follow-up. A further 11 variables showing a significant influence on graft survival in univariate analysis were not included in the final Cox model. CONCLUSION: The long-term results of corneal transplantation are no better than for other forms of transplantation and have shown no measurable improvement over the past 15 years.

Corneal Transplantation↗