dohlman ch, harissi-dagher, m, graney jm. the boston keratoprosthesis: a new threadless design....
TRANSCRIPT
Dohlman CH, Harissi-Dagher, M, Graney JM. The Boston Keratoprosthesis: a new threadless design. Digital Journal of Ophthalmology. Volume 13: Number 3.
5 mm
8.5 mm3 mm
PMMA
Boston Keratoprosthesis: Type 1
PK - penetrating keratoplasty, BCVA - best corrected visual acuity, LSCD – limbal stem cell deficiency, CHED – congenital hereditary endothelial dystrophy, RPM - retroprosthetic membrane
Patient # Age GenderPrevious
PK ComorbidityPre-op BCVA
Post-op BCVA
Follow-up (months) Complications
1 68 M 0 Ocular trauma, Corneal edema, Glaucoma HM 20/60 16 RPM (YAG)
2 66 M 4 Chemical burn, Glaucoma HM 20/50 13
3 67 F 1 Aniridia, LSCD, Glaucoma, Nystagmus HM 20/300 16
4 52 M 3 CHED, Glaucoma CF 20/100 15
5 45 M 0 Aniridia, Glaucoma, Nystagmus 20/300 20/100 15
6 56 M 3 Congenital glaucoma CF CF 11
7 72 M 3 Chemical burn, Glaucoma HM CF 8 RPM (no Tx)
8 68 M 3 Aniridia, LSCD, Glaucoma, Nystagmus HM 20/200 11
9 49 F 3 Immune stromal keratitis, Glaucoma 20/100 20/300 8
10 78 M 5 Infectious ulcer, Glaucoma, High myopia LP 20/200 8
11 53 M 0 Topical anesthetic keratitis, Multiple infectious ulcers HM 20/50 7
12 62 M 0 Stevens Johnson Syndrome CF 20/30 15
13 65 M 1 Aniridia, LSCD, nystagmus 20/400 20/150 14 RPM x2 (YAG)
14 35 F 1 Aniridia, LSCD,Glaucoma Nystagmus CF 20/200 14Inflammation,
RPM (YAG)
15 69 M 2 HSV keratitis, Glaucoma CF 20/150 11 Inflammation
16 38 M 1Traumatic corneal scar,
Fibrous and epithelial ingrowth LP HM 9Inflammation, RPM x3 (YAG)
17 79 M 1 Chronic uveitis, Glaucoma HM CF 4 RPM (YAG)
18 84 F 0 Aphakic bullous keratopathy CF 20/60 4
19 50 F 0 Aniridia, LSCD, Glaucoma, Nystagmus CF 20/200 4
PK - penetrating keratoplasty, BCVA - best corrected visual acuity, LSCD – limbal stem cell deficiency, CHED – congenital hereditary endothelial dystrophy, RPM - retroprosthetic membrane, PCO – posterior capsular opacification
.
Patient # Age GenderPrevious
PK ComorbidityPre-op BCVA
Post-op BCVA
Follow-up (months) Complications
20 57 M 3 Chemical burn, Angle closure glaucoma LP CF 16
21 56 M 0 Pseudomonas ulcer, Angle closure glaucoma HM 20/60 14
22 28 M 0HSV keratitis
HM 20/60 12
Inflammation, RPM (YAG and surgical membranectomy)
23 50 M 1 Aniridia, LSCD, Nystagmus CF 20/300 7
24 50 M 0 Aniridia, LSCD, Glaucoma, Nystagmus 20/150 20/150 11
25 56 F 5 CHED HM 20/300 9
52 F 0 Aniridia, LSCD, Glaucoma, Nystagmus CF 20/100 8Inflammation, RPM
(YAG)
27 59 M 3 HSV keratitis LP 20/60 8
28 66 F 1 Congenital cataract, PBK, Glaucoma CF 20/60 8
29 84 F 0 PBK HM 20/300 7 Inflammation
30 79 F 1 PBK, Glaucoma, Uveitis CF 20/300 6
31 62 M 0 LSCD, Glaucoma HM 20/80 7
32 63 M 1 Aniridia, LSCD, Nystagmus HM 20/200 15 RPM
33 57 M 2 Traumatic corneal scar, aphakia and aniridia 20/300 20/40 6
34 86 M 2 Lattice dystrophy, Glaucoma CF 20/300 9Inflammation, PCO
(YAG)
35 94 F 1 PBK, Glaucoma HM CF 4
36 50 M 2 Traumatic corneal scar, HSV keratitis, Glaucoma LP 20/200 3
37 44 M 0Aniridia, LSCD, Salzmann nodules,
High myopia, Glaucoma LP 20/80 4
BCVA presented as median (range). All others presented as total number or mean +/- standard
deviation.
Fresh corneal graft Frozen corneal graft
Demographics
# patients (total) 19 (5F, 14M) 18 (6F, 12M)
Autoimmune 1 0
Chemical 2 1
Other 16 17
Glaucoma 16 15
Age (years) 61 +/- 14 61 +/- 16
Duration of follow up (months) 10.5 +/- 4 8.5 +/- 4
Best corrected visual acuity
Pre-op BCVA CF (20/100 - LP) HM (20/150 - LP)
Post-op BCVA (3 months) 20/200 (20/30 - HM) 20/150 (20/40 – CF)
Retention 100% 100%
Complications
Leaks, tissue necrosis or melt 0 0
inflammation (sterile uveitis/vitritis) 3 4
Retro-prosthetic membrane 6 3
Infectious endophthalmitis 0 0
Frozen Cornea GroupFrozen Cornea GroupFresh Cornea GroupFresh Cornea Group
Thank you!