Back to Freepaper Session

Boston type 1 keratoprosthesis: visual outcome and complications after surgery

Session Details

Session Title: Cornea

Session Date/Time: Sunday 16/02/2014 | 08:30-11:00

Paper Time: 10:21

Venue: Linhart Hall (Level -2)

First Author: : AngelaDing SPAIN

Co Author(s): :    Gerardo Muñoz-Gutierrez   Juan Alvarez de Toledo   Rafael Ignacio Barraquer   Lourdes Vera   Jeroni Nadal   Maria Fideliz de la paz

Abstract Details

Purpose:

To describe the visual outcome and the complications after surgery in patients treated with Boston type 1 keratoprosthesis (Kpro1)

Setting:

All patients who underwent Kpro1 implantation in the Centro Oftalmologia Barraquer from May 2006 to February 2011.

Methods:

This is a retrospective study which includes All patients who underwent Kpro1 implantation in the Centro Oftalmologia Barraquer from May 2006 to February 2011. Preoperative demographics, postoperative complications and postoperative visual outcome were analized.

Results:

A total of 41 eyes of 37 patients were included in the final analysis, of whom 22 (59.45%) were male and 15 were (40.54%) female. The mean age was 56.44 years (range 2-90). The most frequent diagnoses were bullous keratopathy, autoimmune diseases, such as Stevens-Johnson syndrome (SJS)/Lyell syndrome (LS), and aniridic keratopathy. The mean number of previous keratoplasties (PK) was 2.36 (range 0-8), the mean number of previous non-PK surgeries was 1.58 (range 0-9). The mean follow-up time was 22.17 months (range 3-46). The mean best corrected visual acuity (BCVA) logMAR before surgery was 2.05 (range 1.10-2.52), and the mean best corrected visual acuity achieved after surgery was 1.16 (range 0.08- 2.70). The most frequent complication was the formation of retroprosthetic membrane (RPM) which appeared in 22 (53.65%) eyes. Of these, 6 (27.27%) appeared after another surgery. Fourteen (63.63%) RPM required treatment, an average of 1.71 (range 1-4) laser YAG applications were performed, and surgical membranectomy was performed in 3 patients. Eleven (26.82%) eyes showed chorioretinal adhesion problems, 6 (14.63%) of which occurred after follow-up of BKI surgery. Infectious complications occurred in 7 (17.07%) cases; 2 (4.87%) patients had infectious keratitis and 5 (12.19%) endophthalmitis.

Conclusions:

The Kpro1 provides visual function improvemeny in most patients. Those with prior multiple ocular surgeries and alterations of systemic immunity such as SJS, LS, and diabetes mellitus are at increased risk for serious sight-threatening complications, such as RPM, chorioretinal detachment and infection. Nevertheless, we consider KPro as an effective alternative in patients with multiple ocular pathology and imminent risk of rejection of a new KP. FINANCIAL INTEREST: NONE