Maria Stephanie R Jardeleza1, Marc-Andre Rheaume2, James Chodosh3, Anne Marie Lane4, Claes H Dohlman3. 1. Department of Ophthalmology, University of Texas Health Science Center in San Antonio-Texas Diabetes Institute, San Antonio, Texas; 2. Retina Service, Department of Ophthalmology, University of Montreal, Quebec, Canada; 3. Cornea Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts; 4. Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.
Abstract
PURPOSE: To determine the rates, predisposing factors, and visual outcomes of retinal detachment (RD) after Boston Keratoprosthesis (KPro) implantation. METHODS: In this noncomparative, interventional case series, the medical records of 170 patients (205 eyes) who underwent Boston type 1 and type 2 KPro implantation at the Massachusetts Eye and Ear Infirmary between April 1993 and June 2009 were retrospectively reviewed. Incidence and annual rates of RD were calculated, and the roles of possible predictive factors for RD after KPro were investigated. Main outcome measures were rates of and risk factors for RD, visual acuity after RD, and surgical outcomes after repair. RESULTS: Sterile vitritis and autoimmune systemic disease significantly predisposed patients to RD after KPro placement. Of patients who developed RD after implantation, 50% progressed to visual acuity of no light perception despite surgical repair. CONCLUSIONS: Inflammation plays a major role in RD development after KPro implantation. Patients with predisposing factors should be advised of the high rates of RD and comanaged with a vitreoretinal specialist.
PURPOSE: To determine the rates, predisposing factors, and visual outcomes of retinal detachment (RD) after Boston Keratoprosthesis (KPro) implantation. METHODS: In this noncomparative, interventional case series, the medical records of 170 patients (205 eyes) who underwent Boston type 1 and type 2 KPro implantation at the Massachusetts Eye and Ear Infirmary between April 1993 and June 2009 were retrospectively reviewed. Incidence and annual rates of RD were calculated, and the roles of possible predictive factors for RD after KPro were investigated. Main outcome measures were rates of and risk factors for RD, visual acuity after RD, and surgical outcomes after repair. RESULTS: Sterile vitritis and autoimmune systemic disease significantly predisposed patients to RD after KPro placement. Of patients who developed RD after implantation, 50% progressed to visual acuity of no light perception despite surgical repair. CONCLUSIONS: Inflammation plays a major role in RD development after KPro implantation. Patients with predisposing factors should be advised of the high rates of RD and comanaged with a vitreoretinal specialist.
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