A comparative study of laminar resorption in osteo-odonto keratoprosthesis by clinical methods vs radiological detection

Session Details

Session Title: Cornea: Surgical II

Session Date/Time: Tuesday 08/09/2015 | 14:00-16:00

Paper Time: 14:18

Venue: Room 11

First Author: : J.Smith UK

Co Author(s): :    N. Patel   V. Avadhanam   I. Francis   C. Liu           

Abstract Details

Purpose:

Osteo-odonto-keratoprosthesis (OOKP) patients require life-long follow up as progressive laminar resorption can lead to serious complications. Currently, it is common practice that OOKP patients are screened with regular computerised tomography (CT) scans to identify resorption early such that prophylactic measures can be instituted. However, if surveillance CT scans do not provide benefit, patients will be unnecessarily exposed to high quantities of ionising radiation. This study compares the both clinical and radiological resorption techniques to evaluate whether CT scans are more sensitive at detecting resorption.

Setting:

Sussex eye hospital, Brighton

Methods:

Forty one OOKP patients with a total of 48 laminae were evaluated. Patient' notes were systematically reviewed to identify whether and when during follow-up lamina resorption clinical signs were detected. All CT scans were evaluated to obtain objective 2D linear measurements, estimated 3D volume and clinician's subjective viewpoint. Degree of laminar resorption was graded as a progressive increment from (0 to 3) based on 2D measurements. Significant resorption was considered to be present if grade ≥1. Radiological findings were compared against the clinical findings temporally and spatially.

Results:

Detection of resorption could be compared in time sequence for 25 laminae. Using 2D measurement grading, 3 laminae showed resorption clinically only (12%), 8 laminae had resorption detected clinically which was confirmed on CT (32%), 8 laminae showed resorption on CT first (44%) (2 display CT deterioration to time of clinical detection) and 3 laminae had resorption only on CT (12%). Spatial resorption location could be evaluated in 22 laminae. 6 of these laminae did not match between CT & clinical findings (27%), in 10 laminae it was partially matched (45%) and in 6 cases it was full matched (27%).

Conclusions:

Using 2D measurement analysis, CT scanning can detect OOKP lamina resorption earlier than clinical assessment alone. Clinical assessment has a low accuracy for detecting the location of resorption in the lamina.

Financial Interest:

NONE