8 research outputs found
Heterologous, Fresh, Human Donor Sclera as Patch Graft Material in Glaucoma Drainage Device Surgery
Purpose: To determine the safety and efficacy of fresh, human sclera allografts as a patch graft material in glaucoma drainage device (GDD) surgery. Design: Retrospective, noncomparative, interventional, consecutive case series. Subjects: All GDD cases operated between 2008 and 2013 in which fresh human corneoscleral rims were used immediately after the central corneal button was used for penetrating or endothelial keratoplasty. Methods: Surgery was performed by 2 surgeons at 2 facilities. The Ahmed Glaucoma Valve (FP-7) was used exclusively in this cohort. Sixty-four eyes of 60 patients were identified; demographic data were recorded along with intraocular pressure (IOP), medication requirements, visual acuity, complications, and subsequent interventions. Main Outcome Measures: Incidence of complications. IOP and medication requirements at the last follow-up. Quilified success utilizing Tube Versus Trabeculectomy study criteria. Results: The mean age of the cohort was 66.2±19.1 years; the average preoperative IOP was 33.2±11.1 mm Hg on 4.2±1.3 IOP-lowering agents before GDD surgery. IOP decreased significantly to 14.1±4.7 mm Hg (P<0.001) on 1.6±1.2 IOP-lowering agents (P<0.001) after an average follow-up of 18.2±15.4 months. There were no cases of early or late blebitis or endophthalmitis, and there was 1 case of conjunctival erosion and tube/plate exposure (1.6%) occurring 30 days after surgery. Qualified success was estimated as 90.5% and 81% at 1 and 2 years, respectively, using Tube Versus Trabeculectomy study criteria. Conclusions: Heterologous, fresh, human donor sclera appears to be a safe material for GDD tube coverage. It provides a cost-efficient alternative compared with traditional patch graft materials associated with a low risk of pathogen transmission. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved
The prothrombin time/international normalized ratio (PT/INR) Line: derivation of local INR with commercial thromboplastins and coagulometers--two independent studies.
BACKGROUND: The WHO scheme for prothrombin time (PT) standardization has been
limited in application, because of its difficulties in implementation,
particularly the need for mandatory manual PT testing and for local provision of
thromboplastin international reference preparations (IRP).
METHODS: The value of a new simpler procedure to derive international normalized
ratio (INR), the PT/INR Line, based on only five European Concerted Action on
Anticoagulation (ECAA) calibrant plasmas certified by experienced centres has
been assessed in two independent exercises using a range of commercial
thromboplastins and coagulometers. INRs were compared with manual certified
values with thromboplastin IRP from expert centres and in the second study also
with INRs from local ISI calibrations.
RESULTS: In the first study with the PT/INR Line, 8.7% deviation from certified
INRs was reduced to 1.1% with human reagents, and from 7.0% to 2.6% with rabbit
reagents. In the second study, deviation was reduced from 11.2% to 0.4% with
human reagents by both local ISI calibration and the PT/INR Line. With rabbit
reagents, 10.4% deviation was reduced to 1.1% with both procedures; 4.9%
deviation was reduced to 0.5% with bovine/combined reagents with local ISI
calibrations and to 2.9% with the PT/INR Line. Mean INR dispersion was reduced
with all thromboplastins and automated systems using the PT/INR Line.
CONCLUSIONS: The procedure using the PT/INR Line provides reliable INR derivation
without the need for WHO ISI calibration across the range of locally used
commercial thromboplastins and automated PT systems included in two independent
international studies