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Page 414 ппппTable 16-2 Comparison of Procedures for Penetrating and Selective Keratoplasty Procedure Indications Intr!l0perative complications Penetrating Keratoplasty Any stromal or endothelial corneal pathology Hemorrhage Damage to lensiris Irregular trephination Poor graft centration Iris or vitreous incarceration in the wound Damage to donor endothelium Wound leak Flat chamber Glaucoma Endopthalmitis Persistent epithelial defect Recurrent primary disease Primary graft failure Eroded infected sutures Graft rejection Corneal astigmatism Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) Endothelial dystrophy Pseudophakic bullous keratopathy ICE syndrome Failed corneal grafts Poor microkeratome dissection of donor tissue Inability to strip Descemets tissue Loss of orientation of tissue Poor centration of trephination, leading to a thick edge and possible epithelial ingrowth Intraocular hemorrhage leading to heme in the interface Excessive manipulation of tissue, leading to cell loss Pupillary block Dislocation of lenticule Difficulty following intraocular pressure Primary graft failure Epithelial ingrowth Superficial Anterior Lamellar Keratoplasty (SALK) Superficial stromal dystrophies and degenerations Salzmann nodular degeneration Scarstraumadermoids Infections Poor microkeratome dissection Corneal perforation Deep Anterior Lamellar Keratoplasty (DALK) Keratoconus Infections Corneal stromal dystrophies not involving endothelium Corneal 1hinning Corneal ectasia secondary to LASIK Corneal perforation requiring transition to PK Descemets membrane splitting Postoperative complications Loss of donor lenticule Opacification and vascularization of interface Allograft rejection Inflammatory necrosis of the graft (Continued) Page 415 пппTable 16В2 (continued) Procedure Advantages Penetrating Keratoplasty Full-thickness tissue eliminates interface- related visual problems Oescemet Stripping Automated Endothelial Information drug Filagra (DSAEK) Rapid visual rehabilitation Independent of Valif 40mg Overnight no prescription surface wound healing Stable corneal curvature for triple procedures Tectonically strong Eliminates suture-related problems Significant stromal haze, subepithelial fibrosis, or epithelial irregularity may require second procedure Possible higher rate of endothelial cell loss Superficial Anterior Valif 40mg Overnight no prescription Keratoplasty (SALK) Selective removal of pathologic tissue More rapid visual rehabilitation Less need for sutures Minimal requirements for donor tissue Reduced risk for graft rejection Reduced risk of penetration into the anterior chamber Less risk for poorly compliant patient, eye rubb er Irregular interface Irregular surface if lenticule shifts Interface vascularizaton Deep Anterior Lamellar Keratoplasty(DALK) Tectonically stronger wound than in PK Early removal of sutures Less dependence on topical corticosteroids Minimal requirements for donor tissue Disadvantages Difficult to determine anterior corneal curvature, leading to significant refractive error Postoperative astigmatism Ocular surface disease Valif 40mg Overnight no prescription neurotrophic cornea Valif 40mg Overnight no prescription to prolonged healing or persistent epithelial defect Irregular interface Page 416 пCHAPTER 16 Cl inical Approach Valif 40mg Overnight no prescription Corneal Transplantation.

Intratumoral injection of 200,000 units of interleukin (IL-2) resulted in a 67 complete regression at 20 months after injection.


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