76
|
Di Meglio A, El-Mouhebb M, Michiels S, Jones L, Martin E, Matias M, Lohmann Palhares A, Joly F, Vanlemmens L, Everhard S, Martin A, Lemonnier J, Arveux P, Cottu P, Coutant C, Del Mastro L, Partridge A, André F, Ligibel J, Vaz-Luis I. Weight loss, physical and psychological patient reported outcomes (PROs) among obese patients (pts) with early breast cancer (BC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
77
|
Jahanzeb M, Gilmore T, Roach A, Grubbs S, Blayney D, Hamm J, Kamal A, Kelly R, Martin E, Sanchez J, Siegel R, Crist S, Rosenthal J, Hendricks C. Can measuring quality lead to improvement? Evidence from international participants of ASCO’s quality oncology practice initiative (QOPI®) during 2015-2017. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy297.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
78
|
Rodriguez-Gomez O, Sanabria A, Perez-Cordon A, Sanchez-Ruiz D, Abdelnour C, Valero S, Hernandez I, Rosende-Roca M, Mauleon A, Vargas L, Alegret M, Espinosa A, Ortega G, Guitart M, Gailhajanet A, Sotolongo-Grau O, Moreno-Grau S, Ruiz S, Tarragona M, Serra J, Martin E, Peleja E, Lomeña F, Campos F, Vivas A, Gomez-Chiari M, Tejero MA, Giménez J, Pesini P, Sarasa M, Martinez G, Ruiz A, Tarraga L, Boada M. FACEHBI: A Prospective Study of Risk Factors, Biomarkers and Cognition in a Cohort of Individuals with Subjective Cognitive Decline. Study Rationale and Research Protocols. JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE 2018; 4:100-108. [PMID: 29186280 DOI: 10.14283/jpad.2016.122] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Long-term longitudinal studies with multimodal biomarkers are needed to delve into the knowledge of preclinical AD. Subjective cognitive decline has been proposed as a risk factor for the development of cognitive impairment. Thus, including individuals with SCD in observational studies may be a cost-effective strategy to increase the prevalence of preclinical AD in the sample. OBJECTIVES To describe the rationale, research protocols and baseline characteristics of participants in the Fundació ACE Healthy Brain Initiative (FACEHBI). DESIGN FACEHBI is a clinical trial (EudraCT: 2014-000798-38) embedded within a long-term observational study of individuals with SCD. SETTING Participants have been recruited at the memory clinic of Fundació ACE (Barcelona) from two different sources: patients referred by a general practitioner and individuals from an Open House Initiative. PARTICIPANTS 200 individuals diagnosed with SCD with a strictly normal performance in a comprehensive neuropsychological battery. MEASUREMENTS Individuals will undergo an extensive neuropsychological protocol, risk factor assessment and a set of multimodal biomarkers including florbetaben PET, structural and functional MRI, diffusion tensor imaging, determination of amyloid species in plasma and neurophthalmologic assessment with optical coherence tomography. RESULTS Two hundred individuals have been recruited in 15 months. Mean age was 65.9 years; mean MMSE was 29.2 with a mean of 14.8 years of education. CONCLUSIONS FACEHBI is a long-term study of cognition, biomarkers and lifestyle that has been designed upon an innovative symptom-based approach using SCD as target population. It will shed light on the pathophysiology of preclinical AD and the role of SCD as a risk marker for the development of cognitive impairment.
Collapse
|
79
|
Romero M, Ojeda S, Hidalgo F, Suarez De Lezo J, Mazuelos F, Segura J, Pavlovic DJ, Fernandez A, Luque A, Gonzalez R, Lostalo A, Martin E, Pan M. P5466Impact of the repositionable Evolut R CoreValve on the need for permanent pacemaker after transcatheter aortic valve implantation in patients with severe aortic stenosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
80
|
Pacheco-Barcia V, Donnay O, Solís RM, Serrano R, Martin E, del Campo L, Rogado J, Vera B, Ballesteros A, Colomer R. The impact of primary tumor location in patients with resected colorectal liver metastasis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
81
|
Pacheco-Barcia V, Solís RM, Saez OM, Muñoz FL, Bermejo E, Monteagudo JM, Marin C, Correa A, Maqueda R, Rogado J, de Paredes AG, de Santiago ER, Olmos VP, Monteagudo RF, Garrote MR, Carrato A, Donnay O, Martin E, Santander C, Colomer R. Safety of self-expandable metal stents (SEMS) or emergency surgery for acute colonic obstruction in metastatic colon cancer patients treated with bevacizumab. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
82
|
Pacheco-Barcia V, France T, Zogopoulos G, Bouganim N, Donnay O, Alcindor T, Solís RM, Guo K, Martin E, Colomer R, Asselah J. Gemcitabine plus nab-paclitaxel versus modified FOLFIRINOX as first line chemotherapy in metastatic pancreatic cancer: A comparison of toxicity and survival. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
83
|
Martin E, Michiels S, Paoletti X, Filleron T. Étude par simulation visant à évaluer l’influence de différents paramètres sur les résultats d’un essai randomisé d’algorithme dans le contexte de la médecine de précision. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.03.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
|
84
|
Bahr K, Gouveris H, Huppertz T, Martin E, Matthias C, Muthuraman M. 0327 Distinct Patterns Of EEG-EMG-coherence In Various Stages Of Disease Severity In Patients With Sleep-disordered Breathing. Sleep 2018. [DOI: 10.1093/sleep/zsy061.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
85
|
Crehange G, Cormier L, Bertaut A, Peiffert D, Bolla M, Chapet O, Rio E, De Crevoisier R, Martin E, Cosset J. EP-1581: Salvage brachytherapy and a rectal spacer in locally recurrent prostate cancer after radiotherapy. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31890-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
86
|
Caubet M, Pasquier D, Bertaut A, Grobois S, De Bari B, Kleinclauss F, Thiery-Vuillemin A, Martin E, Quivrin M, Cormier L, Créhange G. EP-1585: Whole pelvic nodal radiotherapy (RT) vs. prostate bed RT after prostatectomy for prostate cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31894-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
87
|
Martin E. *Dr Martin Replies Below. J R Soc Med 2018. [DOI: 10.1177/014107688708001223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
88
|
Martin E. Managing Drug Addiction in General Practice–the Reality Behind the Guidelines: Discussion Paper. J R Soc Med 2018; 80:305-7. [PMID: 3112379 PMCID: PMC1290816 DOI: 10.1177/014107688708000516] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
89
|
Hauswirth C, Fitschen J, Martin E, Oetting G, Hundeshagen H, Ehrenheim C. Zum genetischen Risiko nach hochdosierter Radiojodtherapie unter Berücksichtigung der Gonadendosis. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1629786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Zusammenfassung
Ziel der vorliegenden Arbeit ist die Abschätzung des genetischen Risikos nach hochdosierter Radiojodtherapie unter besonderer Berücksichtigung der individuell erreichten Gonadendosis. Methode: Mittels eines Erhebungsbogens wurden die Daten von insgesamt 364 Patientinnen und Patienten mit einem differenzierten Schilddrüsenkarzinom im gebärbzw. zeugungsfähigen Alter bezüglich ihrer Nachkommen ausgewertet. 45 Patienten (41 Frauen und vier Männer) aus dieser Gruppe hatten insgesamt 56 Kinder. Der Verlauf von Schwangerschaft, Geburt und Kindesentwicklung wurde erfaßt. Ergebnisse: Im Rahmen der Therapie und Nachsorge waren insgesamt zwischen 4,144 und 35,15 GBq I-131 verabreicht worden; die individuell auf der Grundlage des MIRD-Modells errechnete Gonadendosis lag zwischen 0,2 und 2,2 Sv (im Mittel 0,51 Sv). Der Abstand zwischen der letzten I-131 Applikation und einer Geburt betrug mindestens 9 Monate und höchstens 14 Jahre. Bezüglich Schwangerschaftsverlauf und Geburt wurden zwei Frühaborte, eine Extrauteringravidität und eine Plazentainsuffizienz mit nachfolgender Frühgeburt ermittelt. In einem Fall trat eine chromosomale Translokation 7/14 als genetischer Defekt auf, die zur Interruptio führte. Die Entwicklung der ausgetragenen Kinder verlief bis auf das Auftreten einer Neurodermitis in zwei Fällen, multipler Allergien in einem anderen Fall und eines frühzeitigen Fontanellenverschlusses bei einem Kind unauffällig. Schlußfolgerung: Unter der Annahme einer Verdoppelung der Häufigkeit spontaner Mutationen bei einer erzielten Gonadendosis von 1 Sv erhöht sich das Risiko irgendeiner angeborenen Erkrankung bei unseren Patienten im Mittel rechnerisch um rund 13%; tatsächlich lag der Anteil genetischer Defekte in unserem Kollektiv mit 1,8% (1/57) im Bereich des natürlichen Risikos. Unter Berücksichtigung der Literatur ließ sich damit bisher bei insgesamt 408 Kindern keine Zunahme genetisch bedingter Erkrankungen oder angeborener Anomalien feststellen.
Collapse
|
90
|
Potentier C, Martin E, Brousse P, Mosnier E, Henaff F, Guarmit B, Nacher M, Douine M. [Pediatric Morbidity of a Native American Village in French Guiana (2009-2016)]. BULLETIN DE LA SOCIETE DE PATHOLOGIE EXOTIQUE (1990) 2018; 111:167-175. [PMID: 30793571 DOI: 10.3166/bspe-2018-0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/16/2018] [Indexed: 06/09/2023]
Abstract
The situation of the Amerindian village of Camopi in French Guiana is particular because of its geographical isolation and its socio-cultural environment. Does this unique context affect the morbidity of the children? This study describes the morbidity of children aged 0-5 years in Camopi. The study population included all the children living in Camopi, born between 01/01/2009 and 31/12/2013. Sociodemographic and medical data were collected from Child Health Record until 05/01/2016, with a maximum of five years. 149 children were included and received 5916 consultations during the period of study. ENT and upper respiratory diseases were the most frequent diseases that were followed by digestive disorders. Lower respiratory conditions were the leading cause of hospitalization. Tropical diseases were rare. Antibiotics were delivered in 32.5% of the consultations. The vaccination coverage exceeded 95% for BCG, DTP, HBVand yellow fever, remove than that of MMR which was little lower (89.9%) and only 4 children were vaccinated against pneumococcus. Despite the Amazonian context, the morbidity of Camopi's children mainly includes classic disorders. Traumas seem uncommon but can be violent. Facilitating access to rapid diagnostic tests, setting up protocols, and training staff could reduce the prescription of antibiotics.
Collapse
|
91
|
Cijan B, Mukaj M, Bonutti F, Del Dò E, Floreani M, Kishta D, Martin E, Sponza M, Saad AMS. RESULTS FROM A NEW METHOD TO ASSESS THE OCCUPATIONAL LENS DOSE IN INTERVENTIONAL RADIOLOGY. RADIATION PROTECTION DOSIMETRY 2018; 178:95-100. [PMID: 28595335 DOI: 10.1093/rpd/ncx079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 05/23/2017] [Indexed: 06/07/2023]
Abstract
Interventional radiology procedures have always been of particular concern because of the potential high dose to the workers. Special attention has recently been given to the lens dose: in 2011 the ICRP issued the recommendation 'Statement on Tissue Reactions' where a new limit of 20 mSv in a year, averaged over defined periods of 5 years, is given. Due to the impossibility of measuring the dose directly on the eye, there is not still a general consensus on a standardized methodology to assess the lens dose, which should be at the same time reliable, robust and simple to implement in practice. The procedure described here aims to assess the lens dose using the Hp(0.07) equivalent dose measured with a dosimeter worn at chest level above the lead apron, through a correlation with the total KAP per procedure and considering the type of the protection tools used during each procedure: glasses (with lateral shields), ceiling screen, both or neither of them and the frequency of their use.
Collapse
|
92
|
Serrano-Maldonado A, Rozenel SS, Jimenez-Santiago JL, Guerrero-Ríos I, Martin E. Rh nanoparticles from thiolate dimers: selective and reusable hydrogenation catalysts in ionic liquids. Catal Sci Technol 2018. [DOI: 10.1039/c8cy00227d] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Thiolate-capped RhNPs in imidazolium-based ionic liquids were synthesized from [Rh(μ-SR)(COD)]2 dimmers under H2 pressure without external addition of ligand stabilizers, preserving thiolate integrity on the nanoparticle surface. This nanoparticulated systems showed a remarkable selectivity that led to their application in the one pot reductive N-alkylation to produce amines.
Collapse
|
93
|
Geisler V, Bahr K, Huppertz T, Martin E, Winter Y, Tuin I, Matthias C, Gouveris H. Microstructure of respiratory arousals in patients with sleep-disordered breathing. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
94
|
Gouveris H, Boekstegers P, Abriani A, Bahr K, Huppertz T, Martin E, Matthias C, Groppa S, Muthuraman M. Sleep stage classification using spectral analyses and support vector machine algorithm on C3- and C4-EEG signals. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
95
|
Kaplan M, Baker Chowdhury M, Hurwitz J, Metellus V, Martin E, Elie MC. 150 Sepsis Recidivism: Return Visits and Recurrence (S3R Analysis). Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
96
|
Graham S, Martin E, Elie MC. 87 Assessing Compassion Fatigue Among Emergency Department Professionals. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
97
|
Cederberg C, Espe-Pfeifer P, Nopoulos P, Martin E. A-50Neuropsychiatric and Behavior Complexities of Monitoring Progression of Juvenile Huntington's Disease Symptoms: A Case Study of Two Siblings. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx076.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
98
|
de la Caffiniére JY, Martin E, Humbel R, Konsbruck R. [The importance of the thickness of the bone in osteocartilaginous autografts of the rabbit knee]. INTERNATIONAL ORTHOPAEDICS 2017; 6:15-25. [PMID: 27743076 DOI: 10.1007/bf00267811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This experimental study is complementary to the clinical series of cartilaginous autografts in the knee for medial condylar necrosis. The aim was to determine the viability of the articular cartilage in a series of grafts with variable thickness of the underlying spongy bone.The study was done on 36 adult rabbits and the cartilage was studied by biochemical, histochemical and ultrastructural methods. The results are conclusive. The earliest abnormal signs in the first few weeks affect the thinnest grafts of 4 mm whereas the 12 mm thickness grafts hardly show any lesions.It is therefore possible to use large autogenic grafts for osteocartilaginous defects provided the proportion between the area of the articular surface and the underlying spongy bone of the graft is at least 1/4. Under these circumstances, cartilaginous deterioration will be avoided and reduce long term degeneration.
Collapse
|
99
|
Miller SC, Lima JC, Intrator O, Martin E, Bull J, Hanson LC. Specialty Palliative Care Consultations for Nursing Home Residents With Dementia. J Pain Symptom Manage 2017; 54:9-16.e5. [PMID: 28438589 PMCID: PMC5663286 DOI: 10.1016/j.jpainsymman.2017.03.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/20/2017] [Accepted: 03/17/2017] [Indexed: 12/22/2022]
Abstract
CONTEXT U.S. nursing home (NH) residents with dementia have limited access to specialty palliative care beyond Medicare hospice. OBJECTIVES The objective of this study was to examine the value of expanded palliative care access for NH residents with moderate-to-very severe dementia. METHODS We merged palliative care consultation data in 31 NHs in two states to Medicare data to identify residents with consultations, moderate-to-very severe dementia, and deaths in 2006-2010. Initial palliative consultations were identified as occurring later and earlier (1-30 days and 31-180 days before death, respectively). Three controls for each consultation recipient were selected using propensity score matching. Weighted multivariate analyses evaluated the effect of consultations on hospital or acute care use seven and 30 days before death and on (potentially) burdensome transitions (i.e., hospital or hospice admission three days before death or two plus acute care transitions 30 days before death). RESULTS With earlier consultation (vs. no consultation), hospitalization rates in the seven days before death were on average 13.2 percentage points lower (95% confidence interval [CI] -21.8%, -4.7%) and with later consultation 5.9 percentage points lower (95% CI -13.7%, +4.9%). For earlier consultations (vs. no consultations), rates were 18.4 percentage points lower (95% CI -28.5%, -8.4%) for hospitalizations and 11.9 lower (95% CI -20.7%, -3.1%) for emergency room visits 30 days before death; they were 20.2 percentage points lower (95% CI -28.5%, -12.0%) for burdensome transitions. CONCLUSION Consultations appear to reduce acute care use and (potentially) burdensome transitions for dying residents with dementia. Reductions were greater when consultations were earlier.
Collapse
|
100
|
Blériot A, Martin E, Lebranchu P, Zimmerman K, Libeau L, Weber M, Vabres B, Orignac I. Comparison of 12-month anatomic and functional results between Z6 femtosecond laser-assisted and manual trephination in deep anterior lamellar keratoplasty for advanced keratoconus. J Fr Ophtalmol 2017; 40:e193-e200. [PMID: 28601345 DOI: 10.1016/j.jfo.2017.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 04/23/2017] [Accepted: 05/02/2017] [Indexed: 11/19/2022]
Abstract
The management of severe keratoconus requires corneal transplantation, for which the gold standard is deep anterior lamellar keratoplasty (DALK), preserving the healthy Descemet's membrane and endothelium. The safety and reproducibility of corneal cuts have been improved by the evolution of femtosecond lasers in refractive surgery, and femtosecond laser in DALK would seem to provide the same advantages over the manual method. In our retrospective study, we compare functional and anatomical results of femtosecond-assisted DALK versus manual trephination DALK in patients with keratoconus in stage 4 of the Krumeich classification. It is a retrospective study including all patients with stage 4 keratoconus who underwent femtosecond laser-assisted DALK between November 2012 and November 2015 in Nantes university medical center. We compared those patients to a group of patients who underwent manual DALK in the same period, paired by age and maximal keratometry. We assessed visual acuity, pachymetry, endothelial cell density (specular microscopy), and keratometry before surgery and at 4, 8 and 12 months of follow-up. Laser settings and intraoperative complications were recorded. Nineteen patients underwent surgery by femtosecond-assisted DALK, 6 women and 12 men with average age 30.2±10.8 years at transplantation. They were paired with a group of 17 patients who underwent manual DALK in order to compare results. Before surgery, mean visual acuity in the femtosecond group was 0.90 logMAR versus 0.89 logMAR in the manual group, showing no statistically significant difference (P=0.96). Both groups were similar in terms of preoperative age, mean keratometry, pachymetry and endothelial cell density. Average visual acuity post-surgery was 0.27; 0.26; and 0.14 logMAR for femtosecond DALK versus 0.27; 0.17 et 0.25 for manual DALK at 4, 8 and 12 months follow-up respectively, showing no statistically significant difference. After surgery, at 4, 8 and 12 months, mean pachymetry was similar in both groups, and average endothelial cell density was 2390 cells/mm2 for femto DALK versus 2531 cells/mm2 for manual DALK at 12 months of follow-up, showing no statistically significant difference (P=0.5726). The rate of Descemet's membrane microperforations during the procedure was low and similar for both groups. Our study allows for a 12-month follow-up, with assessment of visual recovery, anatomic result and endothelial safety in a series of 19 femtosecond laser-assisted DALK with no statistical significant difference versus the manual trephination group. Femtosecond laser allows for increased reproducibility of the DALK procedure without reducing adverse effects during surgery. Femtosecond laser seems to improve the technique of the DALK procedure, and future developments could improve the reproducibility of DALK even further. A medical economics study would be necessary to determine the cost-effectiveness of femtosecond laser-assisted DALK.
Collapse
|