The Diagnosis of Epithelial Downgrowth After Keratoplasty
During a two-year period we diagnosed and managed four cases of epithelial downgrowth in aphakic patients (two men and two women, 42 to 76 years old) after keratoplasty. Several clinical findings seemed typical of epithelial downgrowth in this setting. When iritis was present, it was unusual in that...
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| Veröffentlicht in: | American journal of ophthalmology 1985-06, Vol.99 (6), p.697-703 |
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| container_title | American journal of ophthalmology |
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| creator | Feder, Robert S. Krachmer, Jay H. |
| description | During a two-year period we diagnosed and managed four cases of epithelial downgrowth in aphakic patients (two men and two women, 42 to 76 years old) after keratoplasty. Several clinical findings seemed typical of epithelial downgrowth in this setting. When iritis was present, it was unusual in that the aqueous humor contained large clumps of cellular material and the degree of apparent inflammation was out of proportion to the ciliary flush or symptoms. A posterior corneal line was present in two cases. It resembled an endothelial graft rejection line, but there were no associated keratic precipitates. Also, no graft edema occurred peripheral to a retrocorneal line in either case. Glaucoma was abrupt in onset and difficult to treat. Cytopathologic studies of aqueous aspirate may be needed to confirm the diagnosis. The long-term prognosis for useful vision in our patients was poor but early diagnosis and surgical intervention might possibly lead to a more favorable outcome. |
| doi_str_mv | 10.1016/S0002-9394(14)76039-8 |
| format | Article |
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Several clinical findings seemed typical of epithelial downgrowth in this setting. When iritis was present, it was unusual in that the aqueous humor contained large clumps of cellular material and the degree of apparent inflammation was out of proportion to the ciliary flush or symptoms. A posterior corneal line was present in two cases. It resembled an endothelial graft rejection line, but there were no associated keratic precipitates. Also, no graft edema occurred peripheral to a retrocorneal line in either case. Glaucoma was abrupt in onset and difficult to treat. Cytopathologic studies of aqueous aspirate may be needed to confirm the diagnosis. 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Several clinical findings seemed typical of epithelial downgrowth in this setting. When iritis was present, it was unusual in that the aqueous humor contained large clumps of cellular material and the degree of apparent inflammation was out of proportion to the ciliary flush or symptoms. A posterior corneal line was present in two cases. It resembled an endothelial graft rejection line, but there were no associated keratic precipitates. Also, no graft edema occurred peripheral to a retrocorneal line in either case. Glaucoma was abrupt in onset and difficult to treat. Cytopathologic studies of aqueous aspirate may be needed to confirm the diagnosis. The long-term prognosis for useful vision in our patients was poor but early diagnosis and surgical intervention might possibly lead to a more favorable outcome.</description><subject>Adult</subject><subject>Aged</subject><subject>Anterior Chamber - pathology</subject><subject>Biological and medical sciences</subject><subject>Cataract Extraction</subject><subject>Cornea - pathology</subject><subject>Corneal Transplantation</subject><subject>Diseases of cornea, anterior segment and sclera</subject><subject>Epithelium - pathology</subject><subject>Eye Diseases - diagnosis</subject><subject>Eye Diseases - etiology</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Ophthalmology</subject><subject>Postoperative Complications - diagnosis</subject><issn>0002-9394</issn><issn>1879-1891</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1985</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1LAzEQhoMoWj9-grAHET2sZppsPk5S_EbBg3oO2eysjWw3Ndkq_nujLb16GoZ5ZublIeQQ6BlQEOfPlNJxqZnmJ8BPpaBMl2qDjEBJXYLSsElGa2SH7Kb0nlshudwm20xpBnw8IvplisWVt299SD4VoS2u536YYudtV1yFr_4thq9hWkzaAWPxgNEOYd7ZNHzvk63WdgkPVnWPvN5cv1zelY9Pt_eXk8fS5SdD2TjWWkdtLWrJkQKTUsPYOiVAsIrVVNVKspyxsVBXrtbOccm4RGhVRW3L9sjx8u48ho8FpsHMfHLYdbbHsEhGCtCCS5rBagm6GFKK2Jp59DMbvw1Q86vM_Ckzvz4McPOnzKi8d7h6sKhn2Ky3Vo7y_Gg1t8nZro22dz6tMQ1ZqagydrHEMMv49BhNch57h42P6AbTBP9PkB8HG4ca</recordid><startdate>19850615</startdate><enddate>19850615</enddate><creator>Feder, Robert S.</creator><creator>Krachmer, Jay H.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19850615</creationdate><title>The Diagnosis of Epithelial Downgrowth After Keratoplasty</title><author>Feder, Robert S. ; Krachmer, Jay H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-dc3fac0ab6b74e01377912ac8616353b08b873939da1b5cb9cc47347e1f850af3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1985</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anterior Chamber - pathology</topic><topic>Biological and medical sciences</topic><topic>Cataract Extraction</topic><topic>Cornea - pathology</topic><topic>Corneal Transplantation</topic><topic>Diseases of cornea, anterior segment and sclera</topic><topic>Epithelium - pathology</topic><topic>Eye Diseases - diagnosis</topic><topic>Eye Diseases - etiology</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Ophthalmology</topic><topic>Postoperative Complications - diagnosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Feder, Robert S.</creatorcontrib><creatorcontrib>Krachmer, Jay H.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Feder, Robert S.</au><au>Krachmer, Jay H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Diagnosis of Epithelial Downgrowth After Keratoplasty</atitle><jtitle>American journal of ophthalmology</jtitle><addtitle>Am J Ophthalmol</addtitle><date>1985-06-15</date><risdate>1985</risdate><volume>99</volume><issue>6</issue><spage>697</spage><epage>703</epage><pages>697-703</pages><issn>0002-9394</issn><eissn>1879-1891</eissn><coden>AJOPAA</coden><abstract>During a two-year period we diagnosed and managed four cases of epithelial downgrowth in aphakic patients (two men and two women, 42 to 76 years old) after keratoplasty. Several clinical findings seemed typical of epithelial downgrowth in this setting. When iritis was present, it was unusual in that the aqueous humor contained large clumps of cellular material and the degree of apparent inflammation was out of proportion to the ciliary flush or symptoms. A posterior corneal line was present in two cases. It resembled an endothelial graft rejection line, but there were no associated keratic precipitates. Also, no graft edema occurred peripheral to a retrocorneal line in either case. Glaucoma was abrupt in onset and difficult to treat. Cytopathologic studies of aqueous aspirate may be needed to confirm the diagnosis. The long-term prognosis for useful vision in our patients was poor but early diagnosis and surgical intervention might possibly lead to a more favorable outcome.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>3893142</pmid><doi>10.1016/S0002-9394(14)76039-8</doi><tpages>7</tpages></addata></record> |
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| ispartof | American journal of ophthalmology, 1985-06, Vol.99 (6), p.697-703 |
| issn | 0002-9394 1879-1891 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Aged Anterior Chamber - pathology Biological and medical sciences Cataract Extraction Cornea - pathology Corneal Transplantation Diseases of cornea, anterior segment and sclera Epithelium - pathology Eye Diseases - diagnosis Eye Diseases - etiology Female Humans Male Medical sciences Middle Aged Ophthalmology Postoperative Complications - diagnosis |
| title | The Diagnosis of Epithelial Downgrowth After Keratoplasty |
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