Chameen Samarawickrama1,2, Nicholas Strouthidis3,4, Mark R Wilkins3. 1. NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK. chameen.sams@sydney.edu.au. 2. Discipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, NSW, Australia. chameen.sams@sydney.edu.au. 3. NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK. 4. Discipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, NSW, Australia.
Abstract
PURPOSE: To evaluate outcomes of Boston keratoprosthesis type 1 (K-Pro) surgery in a cohort of high-risk patients at Moorfields Eye Hospital. Our patients were referred to us at the end-point of their ocular disease. METHODS: A retrospective review of all K-Pro surgery performed between March 2011 and July 2015 with a minimum follow-up of 12 months. RESULTS: 39 eyes of 38 patients were included. Mean follow-up was 28.4 months (range: 12-56). The main indication for surgery was bullous keratopathy from multiple failed grafts (56%). 26 cases (72.2%) had known posterior segment disease pre-operatively. Mean BCVA for the entire cohort (n = 39) initially improved from HM vision to 1/60 before returning to CF vision by 6 months and was maintained for the duration of follow-up. By final follow-up (n = 39), 46% had improved vision (1 line improvement in 10%; 2 lines or more in 36%) and 31% maintained pre-operative visual acuity. Anterior segment pathology was not an independent variable in visual outcome. However, absence of posterior segment disease was significant and performed best, improving from HM to 6/15 and maintaining that vision in the longer term. There were 13 (33%) cases of progressive glaucomatous optic neuropathy, 10 (26%) retinal detachments, 8 (21%) retroprosthetic membranes, 3 (8%) infective keratitis and 2 (5%) vitritis of which 1 progressed to endophthalmitis. In all, 3 (8%) had NPL vision and 4 (10%) required removal of the K-Pro. CONCLUSIONS: Implantation of the Boston K-Pro can lead to improved vision, with the main limiting factor being posterior segment pathology.
PURPOSE: To evaluate outcomes of Boston keratoprosthesis type 1 (K-Pro) surgery in a cohort of high-risk patients at Moorfields Eye Hospital. Our patients were referred to us at the end-point of their ocular disease. METHODS: A retrospective review of all K-Pro surgery performed between March 2011 and July 2015 with a minimum follow-up of 12 months. RESULTS: 39 eyes of 38 patients were included. Mean follow-up was 28.4 months (range: 12-56). The main indication for surgery was bullous keratopathy from multiple failed grafts (56%). 26 cases (72.2%) had known posterior segment disease pre-operatively. Mean BCVA for the entire cohort (n = 39) initially improved from HM vision to 1/60 before returning to CF vision by 6 months and was maintained for the duration of follow-up. By final follow-up (n = 39), 46% had improved vision (1 line improvement in 10%; 2 lines or more in 36%) and 31% maintained pre-operative visual acuity. Anterior segment pathology was not an independent variable in visual outcome. However, absence of posterior segment disease was significant and performed best, improving from HM to 6/15 and maintaining that vision in the longer term. There were 13 (33%) cases of progressive glaucomatous optic neuropathy, 10 (26%) retinal detachments, 8 (21%) retroprosthetic membranes, 3 (8%) infective keratitis and 2 (5%) vitritis of which 1 progressed to endophthalmitis. In all, 3 (8%) had NPL vision and 4 (10%) required removal of the K-Pro. CONCLUSIONS: Implantation of the Boston K-Pro can lead to improved vision, with the main limiting factor being posterior segment pathology.
Authors: Anthony J Aldave; Virender S Sangwan; Sayan Basu; Samar K Basak; Anna Hovakimyan; Ofelya Gevorgyan; Soliman Al Kharashi; Mohanna Al Jindan; Radhika Tandon; Jeena Mascarenhas; Boris Malyugin; Ma Dominga B Padilla; Quresh Maskati; Nisheeta Agarwala; Johan Hutauruk; Manoj Sharma; Fei Yu Journal: Ophthalmology Date: 2012-04-17 Impact factor: 12.079
Authors: Panos G Christakis; Jeffrey W Kalenak; James C Tsai; David Zurakowski; Jeffrey A Kammer; Paul J Harasymowycz; Juan J Mura; Louis B Cantor; Iqbal I K Ahmed Journal: Ophthalmology Date: 2016-08-17 Impact factor: 12.079
Authors: Hall F Chew; Brandon D Ayres; Kristin M Hammersmith; Christopher J Rapuano; Peter R Laibson; Jonathan S Myers; Ya-Ping Jin; Elisabeth J Cohen Journal: Cornea Date: 2009-10 Impact factor: 2.651