[Corneal graft rejection: donor and receiver implication]. / Le rejet de greffe de cornée: implication du donneur et du receveur.

PURPOSE: The purpose of our study was to evaluate the relationship between corneal graft failure and different factors related to both donors and recipients. PATIENTS: and methods: We conducted a retrospective control study on cases treated from January 1998 to December 2000. All records for donors to the eye bank unit of the Sfax forensic medicine department and all records for penetrating keratoplasty operations done in the Sfax Ophthalmology department were reviewed. For every donor we specified age, sex, cause of death, time and corneal deduction technique, as well as storage delay. For every recipient we specified age, sex, keratoplasty indication, state of the cornea, type of anesthetics and intervention. We analyzed the factors for graft rejection taking into consideration all parameters related to donors and recipients using the chi square test, with alpha=0.01. We defined graft rejection as the irreversible corneal edema despite local or general treatment combining corticoids and antivirals. RESULTS: Of the 184 cases followed up, 22 cases (12%) of graft rejection were recorded. Concerning the donor, a statistically significant relation was found between young age and short storage time indicating an increase in the rate of graft rejection. The younger the patient was, the greater the risk, and the longer the tissue had been preserved, the lower the risk of rejection. For the recipient, old age, a history of graft rejection and the state of the receiver bed significantly increased the rate of graft rejection. In terms of surgical stage, the suturing technique and a graft diameter 8 mm or greater increased the rate of graft rejection. CONCLUSION: In addition to neovascularization of the corneal bed and a history of graft rejection, universally recognized as risk factors for transplant rejection, other parameters related to both donors and receivers, such as age, storage time, graft diameter, and suturing technique, must be taken into account in order to ensure the survival of the graft.

[Contusive retinal detachment: a retrospective review of 48 patients]. / Les décollements de rétine post contusifs.

PURPOSE: Analysis of the epidemiological, clinical and therapeutic characteristics of retinal detachment after ocular blunt trauma. MATERIAL AND METHODS: We retrospectively reviewed 48 patients with isolated retinal detachment after ocular blunt trauma, studying their epidemiological characteristics (age, sex and trauma circumstances), their clinic details and the surgical techniques used. RESULTS: The average age of our patients was 39.3 Years; most were male (75%). Assault and home accidents were the most common cause of ocular trauma (83.2%). Total retinal detachment was noted in 47.9%. Of the retinal breaks found, dialysis at the ora serrata was observed in 22%, atrophic holes in 33.9%, retinal breaks in 40.6% and giant tears in 4.2%. Most of the breaks were situated at the lower temporal quadrant. Forty one out of the 48 patients were operated on, with surgical treatment consisting in episcleral surgery in 38 cases and vitreoretinal surgery in three cases. Complete anatomical success was achieved in 92.7%. CONCLUSION: This survey shows that the prognosis of retinal detachment after ocular blunt trauma remains favorable given the young age and the absence of advanced vitreoretinal proliferation, but this should not affect the importance of prevention.