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Ayad A Farjo

Publications and source records attributed to Ayad A Farjo.

9 recordsLinked to original sources
PubMed2006

Extended long-term outcomes of penetrating keratoplasty for keratoconus.

OBJECTIVE: To report graft survival results for initial penetrating keratoplasty (PK) performed more than 20 years ago for keratoconus. Secondary outcome measures included recurrent keratoconus, best spectacle-corrected visual acuity (BSCVA), and rates of glaucoma. DESIGN: Retrospective, consecutive, noncomparative case series. PARTICIPANTS: All patients with clinical and histopathological keratoconus who underwent initial PK at the University of Iowa Hospitals and Clinics from 1970 to 1983. Patients with pellucid marginal degeneration were excluded. METHODS: At baseline, age, preoperative BSCVA, keratometric astigmatism, and host/donor graft sizes for each eye were recorded. Visual acuity and intraocular pressure were followed until the eyes reached 1 of 4 end points: graft failure, recurrent keratoconus, loss to follow-up, or death. Kaplan-Meier survival analysis was performed to estimate the long-term probability of graft failure and recurrent keratoconus. RESULTS: Among the 112 eyes of 84 patients who met entry criteria, there was a mean age at transplant of 33.7 years and preoperative BSCVA of 20/193. With a mean follow-up of 13.8 years (range, 0.5-30.4), 7 eyes (6.3%) experienced graft failure. Recurrent keratoconus was confirmed clinically or histologically in 6 eyes (5.4%), with a mean time to recurrence of 17.9 years (range, 11-27). Kaplan-Meier analysis estimated a graft survival rate of 85.4% and a rate of recurrent keratoconus of 11.7% at 25 years after initial transplantation. Six eyes (5.4%) developed open-angle glaucoma, and 2 eyes required trabeculectomy. At the last follow-up visit, 82 eyes (73.2%) had BSCVA of 20/40 or better. CONCLUSION: Penetrating keratoplasty offers good long-term visual rehabilitation for keratoconus. Relative to other indications for PK, there is a low rate of graft failure. Late recurrence of disease occurs with increasing frequency over time. Given the younger age at which keratoconus patients undergo corneal transplantation, these long-term findings should be incorporated into preoperative counseling.

Adolescent↗
PubMed2006

Salzmann's nodular corneal degeneration clinical characteristics and surgical outcomes.

PURPOSE: To characterize the clinical characteristics and surgical outcomes for Salzmann's nodular corneal degeneration (SNCD). METHODS: In this retrospective, noncomparative, observational case series, all patients coded with a diagnosis of SNCD between January 1, 1996, and April 30, 2002 were included. Cases whose clinical description did not match the classic description of this disorder were excluded. Clinical characteristics, surgical procedures, and qualitative outcomes were recorded. RESULTS: Among 103 patients diagnosed with SNCD, 93 (152 eyes) met inclusion criteria. Eighty-three patients (89.2%) were women (P < 0.00001), and 59 patients (63.4%) had bilateral disease. A normal age distribution was noted, with a mean age of 54.3 years (median, 53 years; standard deviation = 16.9). Meibomian gland dysfunction was noted in 51 patients (54.8%), contact lens wear in 31 patients (33.3%), peripheral vascularization in 29 patients (31.2%), pterygium in 15 patients (16.1%), keratoconjunctivitis sicca in 9 patients (9.7%), and exposure keratitis in 4 patients (4.3%). Forty-nine eyes (32.2%) of 37 patients (39.8%) required a total of 62 surgical procedures. Impaired vision led to 53 (85.5%) of these procedures and resulted in improved vision in 42 (79.2%) of these cases. Seven eyes (4.6%) underwent surgical intervention for subjective discomfort or contact lens intolerance, and all had improved symptoms at last follow-up. CONCLUSIONS: SNCD appears to be a disorder that occurs predominantly in middle-aged women and may be associated with chronic ocular surface inflammation and/or irritation. It is important to diagnose properly because of the good prognosis with medical and surgical therapy.

Adolescent↗
PubMed2006

Scytalidium keratitis: case report in a human eye.

PURPOSE: To describe the presentation and treatment of a case of an atypical reticular corneal infiltrate with surrounding immune-like ring in a young woman caused by Scytalidium fungal species. METHODS: Interventional case report describing the clinical appearance, course, and treatment of Scytalidium keratitis. RESULTS: A 21-year-old female equestrian with a history of soft contact lens wear was noted to have persistent keratitis and photophobia of the right eye after an injury with a volleyball. Although initially culture negative and responsive to topical steroids, the keratitis persisted, and repeat corneal scrapings and cultures revealed Scytalidium species. Treatment with topical amphotericin B 0.15% and oral fluconazole 200 mg twice daily eradicated the infection, and the patient had a final best-corrected visual acuity of 20/20. CONCLUSION: Scytalidium species fungal organisms can cause an indolent keratitis. Intensive oral and topical antifungal therapy was successful in eradicating the infection.

Administration, Oral↗
PubMed2004

Iris-sutured posterior chamber intraocular lens implantation during penetrating keratoplasty.

PURPOSE: To evaluate the clinical indications and postoperative results of iris-sutured posterior chamber intraocular lens implants performed during penetrating keratoplasty. METHODS: Medical records were retrospectively reviewed for preoperative indications and postoperative results of 342 consecutive patients (366 eyes) who underwent iris suturing of a posterior chamber intraocular lens implant during penetrating keratoplasty over a 9-year period. RESULTS: Mean follow-up was 36 months. The principal indications for corneal transplantation were pseudophakic and aphakic bullous keratopathy. Mean postoperative best spectacle-corrected visual acuity was better than preoperatively at all measured time points (P < 0.0001) and improved from 20/474 preoperatively to 20/85 at 1 year. Nine eyes (7.7%) with known preoperative glaucoma required escalation of therapy by medication or surgery to control the intraocular pressure. Seventy-two eyes (29%) without known preoperative glaucoma required treatment of elevated intraocular pressure. Seventy-nine eyes (28%) without known preoperative cystoid macular edema were additionally diagnosed. Mean endothelial cell counts declined throughout the study time frame. Corneal donor rejection episodes occurred in 36 (9.8%) eyes, with the majority having a single episode. Overall, 27 (7.4%) eyes had known graft failure at last follow-up. Two eyes (0.5%) were enucleated following wound disruption. CONCLUSIONS: These long-term results of iris-sutured posterior chamber intraocular lens implants performed during penetrating keratoplasty suggest acceptable visual acuity, graft survival, and complication rates. They are similar to published retrospective and prospective results of flexible open-loop anterior chamber and transsclerally-sutured posterior chamber intraocular lens implants placed during penetrating keratoplasty.

Adult↗
PubMed2003

Phacoemulsification in eyes with corneal opacification.

We describe a technique in which transcorneal illumination with a fiber-optic light probe is used to safely perform phacoemulsification in cataractous eyes with dense corneal opacification. The technique was used in 3 eyes of 3 patients. No surgical complications occurred, and all eyes had improved visual acuity. Indications and further refinement of the technique and instrumentation are discussed.

Adult↗