Avtor/Urednik		Pahor, Dušica; Gračner, Bojan
Naslov		Penetrantna keratoplastika pri duševno manj razvitih bolnikih
Prevedeni naslov		Penetrating keratoplasty in mentally retarded patients
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 71, št. Suppl 2
Leto izdaje		2002
Obseg		str. II-43-4
Jezik		slo
Abstrakt		Background. Penetrating keratoplasty (PK) is rarely performed in mentally retarded patients, first of all because of numerous complications after surgery such as inflammation, self-inflicted injury, injury and because of difficult post-operative treatment. The aim of this study was to present the success of PK in this patients. In 16 years (from May 1984 to May 2000) 201 PK were performed, but only three in mentally retarded patients. Methods. We present three cases of PK in mentally retarded patients. All the patients were men. They were 14, 16 and 27 year old. The indication for PK were in two cases acute keratoconus and in one case acute keratoglobus. The mean follow-up was 24.6 months. Trepanation was made with rotor threpin and donor material was sutured using single continuous 10-0 nylon suture. Results. In two cases keratoplasties stayed clear. Visual acuities were 0,4 and 0,5. In one patient with very aggressive behaviour graft failure developed with significant corneal vascularisation. Re-keratoplasty was not performed. Conclusions.Adequate post-operative care following PK in mentally retarded patients is the most important factor for the success of transplantation. The indication for the surgery must be made very carefully especially in self-aggressive patients in residential care.
Izvleček		Izhodišča. Penetrantna keratoplastika (PK) se redko opravi pri duševno manj razvitih bolnikih predvsem zaradi številnih zapletov po operaciji, kot so vnetja, samopoškodbe, poškodbe in težje spremljanje. Namen prispevka je prikazati uspešnost PK pri teh bolnikih. V obdobju 16 let (od maja1984 do maja 2000) je bila narejena 201 PK, od tega le tri pri duševno manj razvitih bolnikih. Metode. Prikazani so trije primeri PK pri duševno manj razvitih bolnikih. Vsi bolniki so bili moškega spola, stari 14, 16 in 27 let. Vzrok za operacijo je bil v 2 primerih akutni keratokonus in v enem primeru akutni keratoglobus. Trepanacija je bila narejena z rotorskim trepanom in transplantat zašit z enojnim tekočim najlonskim šivom 10-0. Povprečno pooperativno spremljanje je bilo 24,6 meseca. Rezultati. Pri dveh bolnikih sta ostala transplantanta prozorna, vidna ostrina je bila 0,4 in 0,5. Pri enem bolniku, kjer sta bila zdravljenje in pooperativno spremljanje izredno težka, je prišlo do postopne skalitve transplantata z vaskularizacijo. V nobenem primeru ni bila potrebna ponovna keratoplastika. Zaključki. Dobro pooperativno spremljanje duševno prizadetih bolnikov po PK je odločilnega pomena za uspeh transplantacije. Zato je potrebno imeti stroge indikacije za tak poseg, zlasti kadar gre za avtoagresivne bolnike, ki živijo v zavodih.
Deskriptorji		KERATOCONUS KERATOPLASTY, PENETRATING MENTAL RETARDATION TREATMENT OUTCOME