Cole Eye Institute - Cleveland Clinic

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4000 2000 0 Many serious sight-threatening disorders may affect only the surface of the eye, including the cornea. These conditions may disrupt or destroy the corneal stem cells responsible for producing the eye’s healthy cellular surface. Cleveland Clinic surgeons have performed a number of stem cell transplants to restore the ocular surface. In addition, they have created a device that facilitates harvesting the tissue from deceased donor tissue. For patients with serious disorders who are not candidates for the more common types of corneal transplantation, the cornea may be replaced with an artificial cornea, called a keratoprosthesis. Several of our patients Intraoperative have benefited Complications from this procedure, with excellent visual and anatomical results. Intraoperative Complications N = 223 0.4% Choroidal Hemorrhage 0.4% Corneal Graft Edema 99.2% None A total of 205 keratoplasty procedures and 18 other corneal procedures with a total of 223 procedures were performed during the previously mentioned period. The vast majority of patients have had successful clinical outcomes with no complications. Intraoperative complications occurred in only 0.9 percent of cases; they consisted of corneal graft edema and choroidal hemorrhage. The postoperative complication rate was 2.7 percent, with most complications being retinal detachment, graft failure and persistent epithelial defect. The reoperation rate after corneal surgery (defined as a return to the OR within 90 days) was 3.8 percent; this was due to failure of graft adhesion in DSAEK cases. Analysis of intraoperative complications included all surgical procedures performed during this period. Analysis of postoperative complications and surgical outcomes included those patients who had completed three months or more of follow-up. Consequently, the sample sizes reported for intraoperative and postoperative complications differ. Outcomes 2007 10
Postoperative Complications 80 60 40 20 0 Change in visual acuity based on the type of corneal transplant procedure is shown in the graph below. For patients who completed at least three months of follow-up, the mean improvement in ETDRS visual acuity score was 23.9 letters, corresponding to an improvement of five lines of visual acuity. Change in Visual Acuity by Procedure 80 60 40 20 0 N = 222 ETDRS Visual Acuity Score 0.5% Retinal Detachment 0.5% Graft Failure Keratoprosthesis Text 7.5 point Roman Axis labels 7.5 Bold Lamellar Keratoplasty Type of Procedure Penetrating Keratoplasty Axis line weight = 1 Line weight for bars and pie pieces = 0.5 Use stacked bar sequence shown Dashed line weight = 0.75 Dash 2 Gap 1 0.5% Persistent Epithelial Defect 0.9% Other 97.7% None Preop VA Postop VA 11 Cole Eye Institute
Page 1 and 2: 1 Cole Eye Institute Outcomes | 200
Page 3 and 4: 1 Outcomes 2007 Quality counts when
Page 5 and 6: what’s inside Chairman’s Letter
Page 7 and 8: Institute Overview At Cleveland Cli
Page 9 and 10: Cataract Surgery 7 Complications du
Page 11: Cornea Surgery Corneal transplant s
Page 15 and 16: Change in Intraocular Pressure Intr
Page 17 and 18: Oculoplastic Surgery Oculoplastic s
Page 19 and 20: Ocular Oncology Surgery A melanoma
Page 21 and 22: Refractive Surgery 100 Outcomes 80
Page 23 and 24: Vitreoretinal Surgery 60 50 The vit
Page 25 and 26: An analysis of intraoperative compl
Page 27 and 28: Surgical Outcome for Adults N=151 1
Page 29 and 30: Innovations Retinopathy of Prematur
Page 31 and 32: Advanced Corneal Imaging Sheds Ligh
Page 33 and 34: Jeng BH, Holland GN, Lowder CY, Dee
Page 35 and 36: Book Chapters Bollinger K, Smith SD
Page 37 and 38: Uveitis Careen Y. Lowder, MD, PhD O
Page 39 and 40: Cleveland Clinic Overview Online Se

Cole Eye Institute - Cleveland Clinic

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