First Author: T.Triwijayanti INDONESIA
Co Author(s): J. Hutauruk
Purpose:
This is a case report of complicated case of multiple failed corneal graft which succesfully managed by Boston K-Pro firstly done in Indonesia
Setting:
The Boston Keratoprosthesis (K-Pro) is an " artificial cornea" that can be used in severe corneal opacity. The Boston K-Pro is a proven primary treatment option for repeat graft failure. Graft failure due to surface problem was associated with corneal scarring or previous graft failure. Severe proptosis in Graves orbitopathy can cause damage of the cornea and usually in condition that cannot be improved by other treatment, corneal graft is an option.
Methods:
45-year-old male was diagnosed as hyperthyroid, he came to RSCM in 2008 with perforated corneal ulcer with hypopion of the left eye in Graves ophthalmopahty. He was treated with blepharoraphy. In June 2010 he came again to RSCM with history of twice keratoplasty surgery on the right eye because of exposure keratitis. Visual acuity of both eyes were hand movement, severe lid retraction, exophthalmos and lagophthalmos, and bilateral leucoma in cornea. He underwent orbital decompression in june 2010. In December 2010, visual acuity both eyes were light perception, with graft failure of the right eye and lecoma adherent of the left eye. In January 2011, he underwent keratoplasty RE with Boston K-pro and tube shunt.
Results:
The visual acuity improved to 6/20 at the last follow-up, IOP increase in palpation. Fundus examination revealed pre retinal and vitreous heamorrage but not covered visual axis. From fundus examination the ONH was pale and C/D ratio was 0.9. He was diagnosed as secondary glaucoma RE.
Conclusions:
The Boston Keratoprothesis is indicated when standard corneal transplant would be unlikely to succeed. Glaucoma is one of the most common complication of this procedure. Successful outcome requires patient compliance and need close post-surgical follow up. FINANCIAL DISCLOSURE?: No
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