Case Reports

Anterior segment reconstruction with Boston type 1 keratoprosthesis after penetrating trauma with foreign body: a case report

Case Report Details

First Author: A.Davtyan ARMENIA

Co Author(s):    A. Hovakimyan                    

Abstract Details

Purpose:

The purpose of this case report is presenting a unique case when 3 devices (Ahmed valve, Morcher artificial iris and lens, Boston type 1 keratoprosthesis) can be implanted in the same eye as well as to highlight the importance of keratoprosthesis in anterior segment reconstruction for vision restoration.

Setting:

Keratoprosthesis is an artificial corneal replacement, which is used for visual improvement of corneal blindness. Common indications for the Boston keratoprosthesis type 1 device include corneal allograft rejection, corneal opacity with extensive corneal neovascularization, limbal stem cell deficiency including aniridia, SJS, OCP and mild to moderate chemical injury, etc.

Report of Case:

Patient 45 y/o male with a history of penetrating trauma was admitted at ocular emergency department 7years ago. Sclerocorneal wound was present with lens and iris extrusion. The patient underwent immediate pars plana vitrectomy and foreign body removal with silicone oil replacement, 6 months later the silicone oil was removed. He developed glaucoma and underwent Ahmed valve implantation. One year later the artificial iris and lens complex was implanted. He underwent penetrating keratoplasty because of corneal decompensation. But the graft was failed during one year and second penetrating keratoplasty was performed. The second graft was rejected as well. After two graft rejections the patient underwent Boston type 1 keratoprosthesis 4 years ago. The visual acuity improved from LP to 20/80 remaining stable till now.

Conclusion/Take Home Message:

Boston type 1 keratoprosthesis is a good option for visual restoration in challenging cases when traditional types of keratoplasty are failed as well as it could be compatible with artificial iris and Ahmed valve devices.

Financial Disclosure:

None