Boston Type 1 Keratoprosthesis for Chemical and Thermal Injury

Abstract

The Boston Kpro-1 is associated with highly satisfactory visual outcomes and prosthesis retention in most cases of severe chemical or thermal injury. Serious complications are common and may compromise the final outcome.

Microbial Keratitis and Endophthalmitis After the Boston Type 1 Keratoprosthesis

“…5 The KPro-1 optic does not depend on a healthy corneal epithelium or precorneal tear film to provide satisfactory visual acuity, a feature that is particularly beneficial in eyes with chronic ocular surface disorders. 6,7 However, these visual benefits can be compromised by ocular surface-related issues that contribute to the development of microbial keratitis [8][9][10] and/or endophthalmitis [11][12][13][14][15] and the resultant potential for device extrusion and irreversible ocular injury. 16 Multiple management strategies have been introduced to reduce vision-threatening postoperative infections after keratoprosthesis implantation.…”

The Role of Titanium Surface Microtopography on Adhesion, Proliferation, Transformation, and Matrix Deposition of Corneal Cells

“…Longterm cell response was evaluated at 1.5 months using culture samples seeded at~10 5 /disk initial cell density. At the end of experiments, cells were fixed with 4% paraformaldehyde (PFA) and incubated with mouse monoclonal antibody against a-SMA (1:150; ab7817; Abcam, Cambridge, MA, USA), rabbit polyclonal antibody against collagen type I (1:150; ab34710; Abcam), or rabbit polyclonal antibody against collagen type V (1:150; NB120-7046; Novus, Littleton, CO, USA), and then treated with Alexa Fluor 647 conjugated secondary antibody, Alexa Fluor 488 conjugated phalloidin (Molecular Probes, Eugene, OR, USA) for F-actin expression, and 4 0 ,6-diamidino-2-phenylindole (DAPI) (Santa Cruz Biotechnology, Santa Cruz, CA, USA) to stain cell nuclei.…”

“…4,5 The design is composed of a ''collar-button'' front plate with a stem, a Ti back plate, and a donor carrier cornea clipped between the front and back plates and sutured to the host cornea (Fig. 1).…”

Boston Type 1 Keratoprosthesis for Iridocorneal Endothelial Syndromes

“…Irrespective of the original surgical indication for keratoplasty, there is a common requirement for postoperative escalation of medical and surgical glaucoma therapy after KPro-1. [17][18][19][20][21][22][23][24] Our own experience in this, and previously published series, [20][21][22][23][24] suggests that the rate of glaucoma therapy escalation is only slightly higher when the original surgical indication is strongly associated with a glaucoma syndrome. Among 17 eyes with an original surgical indication of congenital glaucoma, 23 aniridia, 24 or ICE (current series), 4 (23.5%) required escalated therapy.…”

“…Among 17 eyes with an original surgical indication of congenital glaucoma, 23 aniridia, 24 or ICE (current series), 4 (23.5%) required escalated therapy. Among 42 eyes with an original surgical indication of endothelial dystrophy, 20 trauma, 20 keratoconus, 20 chemical injury, 21 or herpetic keratitis, 22 6 (14.3%) required additional therapy. However, progressive optic neuropathy with severe vision loss occurred only in 2 eyes with congenital glaucoma 24 and 1 eye with ICE.…”