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Pneumatic retinopexy vs scleral buckling: a randomized controlled trial.
acute and chronic immune reactions was clear 3 years postoperatively. Fifty-six percent of all acute immune reactions occurred during the first postoperative year, 82% during the first 2 years, and 91% during the first 3 postoperative years. For chronic immune reac tions, the corresponding values reached 51%, 94%, and 100%. The authors conclude that after pene trating keratoplasty in normal-risk patients, acute immune reactions occur more often than chronic immune reactions; if immune reactions are treated in a timely manner, they may not lead to graft failure. — Thomas J. Liesegang "University Eye Hospital, Heinrich-Heine-University, Moorenstrasse 5, Dusseldorf D-40225 Germany.
• Infiltrating inflammatory cell phenotypes and apoptosis in rejected human corneal allografts. Larkin DFP*, Alexander RE, Cree IA. Eye 1997; 11:68-74.
T
HE AUTHORS SURVEYED THE
HISTOPATHOLOGIC
and immunohistochemical features of rejected corneal allografts. Paraffin-embedded specimens of 17 corneal transplants that failed because of rejection were examined. Nine were thefirstgraft, four were the second graft, and four were the third graft for the patient. Grafts that were removed earliest following onset of rejection had the most intense graft inflam matory infiltrates. Immunohistochemical staining showed a high proportion of graft stroma- infiltrating cells expressing leukocyte common antigen, and many of these cells also bore T-cell or macrophage markers. Leukocyte-keratocyte apposition and region al loss of keratocytes were observed in all rejected specimens but not in nonrejected control grafts. In situ end-labeling of DNA double-strand breaks and morphologic features identified keratocyte apoptosis in five of 12 specimens. Corneal endothelial cells were absent in seven specimens and present in reduced numbers in the remaining 10. The authors conclude that endothelial cell monolayer attenuation and keratocyte loss are consistent findings in grafts
VOL.124, No. 3
removed subsequent to clinically observed endotheli al rejection. Death of donor corneal cell is mediated, at least in part, by apoptosis. The stromal inflammato ry infiltrate consists mainly of T lymphocytes and macrophages, which may be responsible for induction of keratocyte apoptosis. — Thomas J. Liesegang *Moorfields Eye Hospital, City Rd, London EC1V 2PD, UK.
• Pneumatic retinopexy vs scleral buckling: a randomized controlled trial. Mulvihill A*, Fulcher T, Datta V, Acheson R. Irish J Med Science 1996; 165:274-277.
P
NEUMATIC RETINOPEXY (PR) IS A TECHNIQUE FOR
repairing certain retinal detachments that is easi er to perform than conventional scleral buckling (SB) surgery and may have comparable results. The authors performed a prospective, randomized, controlled trial comparing the two techniques at their institution. Twenty patients presenting consecutively with retinal detachments who fulfilled the selection criteria were randomly assigned to have their detachments re paired by either PR or SB, with 10 patients in each group. The suitable patients had a single retinal break or a small group of breaks of not greater than 1 clock hour in size, situated within the superior 8 clock hours of retina. Patients with significant proliferative vitreoretinopathy or other fundus disorders were excluded. All patients in the PR group had local anesthesia whereas all those in the SB group had general anesthesia. Successful reattachment of the retina was achieved with one or more procedures in 90% of the PR group and 100% of the SB group. The authors suggest that narrowing the selection criteria for PR may further improve the success rate. They suggest specifically that it might be limited to patients with a single retinal break, to those who are phakic, and to breaks that are in the superior fundus only. — Thomas J. Liesegang "Department of Ophthalmology, Mater Misericordiae Hospital, Eccles St, Dublin 7, Ireland.
ABSTRACTS
427
• Infiltrating inflammatory cell phenotypes and apoptosis in rejected human corneal allografts. Larkin DFP*, Alexander RE, Cree IA. Eye 1997; 11:68-74.
T
HE AUTHORS SURVEYED THE
HISTOPATHOLOGIC
and immunohistochemical features of rejected corneal allografts. Paraffin-embedded specimens of 17 corneal transplants that failed because of rejection were examined. Nine were thefirstgraft, four were the second graft, and four were the third graft for the patient. Grafts that were removed earliest following onset of rejection had the most intense graft inflam matory infiltrates. Immunohistochemical staining showed a high proportion of graft stroma- infiltrating cells expressing leukocyte common antigen, and many of these cells also bore T-cell or macrophage markers. Leukocyte-keratocyte apposition and region al loss of keratocytes were observed in all rejected specimens but not in nonrejected control grafts. In situ end-labeling of DNA double-strand breaks and morphologic features identified keratocyte apoptosis in five of 12 specimens. Corneal endothelial cells were absent in seven specimens and present in reduced numbers in the remaining 10. The authors conclude that endothelial cell monolayer attenuation and keratocyte loss are consistent findings in grafts
VOL.124, No. 3
removed subsequent to clinically observed endotheli al rejection. Death of donor corneal cell is mediated, at least in part, by apoptosis. The stromal inflammato ry infiltrate consists mainly of T lymphocytes and macrophages, which may be responsible for induction of keratocyte apoptosis. — Thomas J. Liesegang *Moorfields Eye Hospital, City Rd, London EC1V 2PD, UK.
• Pneumatic retinopexy vs scleral buckling: a randomized controlled trial. Mulvihill A*, Fulcher T, Datta V, Acheson R. Irish J Med Science 1996; 165:274-277.
P
NEUMATIC RETINOPEXY (PR) IS A TECHNIQUE FOR
repairing certain retinal detachments that is easi er to perform than conventional scleral buckling (SB) surgery and may have comparable results. The authors performed a prospective, randomized, controlled trial comparing the two techniques at their institution. Twenty patients presenting consecutively with retinal detachments who fulfilled the selection criteria were randomly assigned to have their detachments re paired by either PR or SB, with 10 patients in each group. The suitable patients had a single retinal break or a small group of breaks of not greater than 1 clock hour in size, situated within the superior 8 clock hours of retina. Patients with significant proliferative vitreoretinopathy or other fundus disorders were excluded. All patients in the PR group had local anesthesia whereas all those in the SB group had general anesthesia. Successful reattachment of the retina was achieved with one or more procedures in 90% of the PR group and 100% of the SB group. The authors suggest that narrowing the selection criteria for PR may further improve the success rate. They suggest specifically that it might be limited to patients with a single retinal break, to those who are phakic, and to breaks that are in the superior fundus only. — Thomas J. Liesegang "Department of Ophthalmology, Mater Misericordiae Hospital, Eccles St, Dublin 7, Ireland.
ABSTRACTS
427