[Corneal transplantation in Hungary. Data of the National Keratoplasty Registry 1992-1996]. / Szaruhártya-átültetés Magyarországon. Az Országos Keratoplasztika Regiszter 1992 és 1996 közötti idöszakra vonatkozó adatai.

Upon the request of the National Transplantation Committee a nationwide keratoplasty register is functioning at the Department of Ophtalmology, University Medical School of Debrecen. Since then at the end of each year we collected data from the University Departments and Hospitals performing corneal transplantation concerning their keratoplasties and related activities. According to the acquired data the number of corneal transplantations performed in Hungary was 299 in 1992, 298 in 1993, 320 in 1994, 426 in 1995, and 479 in 1996. Keratoplasties in Hungary were performed in 6 University Departments and in 13 Hospitals, all together in 19 institutions in the past five years. The overwhelming majority of corneal transplantations (in 1995 95.8% and in 1996 96.4%) were penetrating keratoplasties. The ratios of lamellar keratoplasties in 1995 and in 1996 were 3.0% and 2.5%, respectively. The ratios of sclerokeratoplasties were slightly above 1% in both years. The distributions of implanted fresh and preserved (eye bank) corneas were around 50-50% in these two years so, that in 1995 a somewhat more and in 1996 somewhat less preserved corneas were used. This ratio for preserved corneas was less than 20% in the period between 1992 and 1994. The law regulating the procurement and the transplantation of corneas is based on presumed consent and explicit objection which is the better type of regulation for the performance of keratoplasties in large numbers. The number of corneal transplantations in Hungary in the past years was close to the figures of industrial countries (England, Germany) calculated for similar populations, inspite of the fact that financing was in many respects unacceptable.

Euthyroid infiltrative ophthalmopathy: clinical-immunological characteristics.

The thyroid hormone titres of the sera of 25 euthyroid infiltrative ophthalmopathic patients was examined, TRH test was performed, and thyroid-stimulating antibodies were studied by membrane receptor assay and TRAK assay. Previously, other diseases causing exophthalmos could be excluded by ophthalmological, radiological examinations, orbital ultrasonography and/or CT. Following TRH administration, 18 out of 25 patients showed abnormal TSH response, 16 of them were TSI - positive. Five of them became hyperthyroid 2-2.5 years later. After TRH administration 7 patients produced normal TSH response, none of them became hyperthyroid in the subsequent 2-4 years follow-up period. In the 7 TRH-negative patients, four were found to have higher hTG and an antithyroid microsome antibody titre. In those patients the fine needle biopsy verified chronic lymphocytic thyroiditis. In three patients there was no evidence of a pathological change of the thyroid gland. Based on our results, the patients could be divided into three groups. The prognostic and therapeutic differentiation of these groups seems to be justified.

Change of T-lymphocyte ratio after keratoplasty.

Changes in the ratio of active and total E rosettes of 12 untreated and 26 corneal transplant patients with immunosuppressive therapy were examined weekly for a month and in the third month. On the basis of our results it can be stated that keratoplasty increases immune reactivity. This manifests itself in the increasing number of both the active and total E-rosette-forming lymphocytes. This increase in T cell number can be observed also after cataract operations in the first week, but in the latter case if no rejection occurs after keratoplasty the ratio of E-rosette-forming cells returns to the preoperative value in the third week. If the T-lymphocyte number is increased as late as the third week, that can be regarded as a rejection sign. Our data confirm the significance of active E-rosette-forming cells in immunological processes. Examination of the active and total E-rosette-forming T-lymphocytes has proved a suitable method for following up the cellular immunological processes directed against the corneal transplant.

[Ophthalmologic studies of chronic hemodialysis patients]. / Ophthalmologische Untersuchungen von chronischen Hämodialyse-patienten.

The authors have examined 27 patients who participate in the chronic haemodialysis programme. It was established that the hyperphosphataemia, the hypocalcaemia and the later hypercalcaemia which developed in consequence of the chronic renal insufficiency are the cause of the calcification of the cornea and of the conjunctiva. In order to pursue this process the slit-lamp examination is recommended as necessary and useful method. The authors consider frequent neither the existence of the "red eye" symptom nor the development of a cataract.