Survival of an eight-year-old child with a very severe high-tension electrical burn injury: a case report.

We present the management and survival of an eight-year-old boy with a severe high-tension electrical burn injury of 68% of total body surface area in a surgical intensive care unit, as a result of a well-planned and applied treatment strategy. Subsequent to escharotomy and fasciotomy operations under general anesthesia, the patient was taken into the surgical intensive care unit. In addition, patient underwent nine more operations including right femur disarticulation and split-thickness skin graftings with homografts from his brother and autografts. The patient was connected to mechanical ventilator for 59 days. By the time the patient was transferred to plastic and reconstructive surgery ward, he was fully conscious, cooperated and hemodynamically stable.

Ten-year follow-up of epikeratophakia for the correction of high myopia.

OBJECTIVE: To determine the long-term functional results of epikeratophakia for myopic patients. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Twenty-two patients (32 eyes; average age, 43+/-6 years) who underwent epikeratophakia surgery for high myopia. Mean preoperative myopia was -18.74+/-9.16 diopters (D; range, -7 D to -49 D). Follow-up was 12+/-2 years. MAIN OUTCOME MEASURES: Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), change in mean keratometry, visual acuity under glare conditions, BCVA versus potential acuity meter reading, and patient satisfaction with the visual outcome. RESULTS: Mean preoperative UCVA increased from 20/800+/-20/400 (range, counting fingers-20/400) to 20/80+/-20/200 (range, 20/250-20/32) in 24 eyes. Mean preoperative BCVA of 20/32+/-20/64 increased only in five eyes, whereas six eyes had no change and 18 eyes had a more than one line loss of Snellen BCVA. Mean preoperative keratometry reading decreased from 43.67+/-0.90 D (range, 41.0-46.25 D) to 37.40+/-2.92 D (range, 29.43-47.68 D). In the presence of glare, mean BCVA decreased to 20/100+/-20/100 (range, counting fingers-20/32). Potential acuity meter (PAM) readings were significantly (P<0.05) higher than BCVA. Mean PAM reading was 20/25+/-20/100 (range, 20/100-20/16). Seven patients (11 eyes) were extremely satisfied with the operative result more than 10 years after the operation, whereas four patients (four eyes) were not satisfied at all. CONCLUSIONS: Epikeratophakia for the correction of myopia improved UCVA significantly, but BCVA decreased. The removal of the lenticules in patients who were not satisfied with their visual acuity was uncomplicated, and acceptable vision could be achieved with either contact lenses or intraocular lens implantation.

Corneal sensitivity 10 years after epikeratoplasty.

PURPOSE: To assess corneal sensitivity in patients 10 or more years after epikeratoplasty for myopia, aphakia, hyperopia, and keratoconus. METHODS: A total of 45 eyes of 33 patients (age range at examination 33 to 55 yr) were included in the study. Corneal sensitivity thresholds using an electromagnetic aesthesiometer (Draeger) were measured at various locations on the lenticule and the recipient cornea. Measurements were evaluated regarding the corrective purpose, surgical technique, age, and gender of the patients and the area of measurements. RESULTS: The mean corneal sensitivity threshold in the center of the epikeratoplasty lenticule was significantly lower than on the peripheral recipient cornea (320.0 +/- 365.1 x 10(-5) N versus 0.1 +/- 0.5 x 10(-5) N). Corneal sensitivity at the 3 and 9 o'clock positions was significantly higher compared to the values at the 6 and 12 o'clock positions on the lenticule. No correlations of these values with age, gender, type, and primary indications for the surgery were observed. CONCLUSIONS: These results indicate a relative hypesthesia of the epikeratoplasty lenticule as compared to the peripheral host cornea, even 10 years after surgery. In our patients no clinically significant changes were observed that could be attributed to the reduced sensitivity over this follow-up period.