Boston Type 2 keratoprosthesis- mid term outcomes from a tertiary eye care centre in India

Iyer, Geetha; Srinivasan, Bhaskar; Agarwal, Shweta; Ravindran, Ramya; Rishi, Ekta; Rishi, Pukhraj; Sripriya, Krishnamoorthy

doi:10.1016/j.jtos.2018.08.003

Cited by 28 publications

(14 citation statements)

References 9 publications

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“…Given the high risk for complications, the Boston Type 1 Kpro is not routinely recommended in moist SJS eyes. The outcomes of different kpro devices in eyes with SJS/TEN such as the modified osteoodonto keratoprosthesis, the Boston Type 2 Keratoprosthesis, the LVP keratoprosthesis, and the Lux keratoprosthesis have been published from India (38)(39)(40)(41)(42). Although the incidence of complications are higher in eyes with SJS/TEN, the outcomes with all the keratoprostheses devices have been shown to be encouraging in patients with end-stage corneal blindness.…”

Section: Keratoprosthesis In Sjs/tenmentioning

confidence: 99%

Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

et al. 2021

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Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a spectrum of rare, severe immunological blistering skin reactions which are triggered by medication intake or infections. The acute phase is characterized by necrolysis of the skin and desquamation of mucosa, primarily oral and ocular, with significant mortality rates. The chronic phase is characterized by multi-organ sequelae with increased rates of morbidity and reduced quality of life for patients who have survived the acute phase. Since the primary goal in the acute phase is saving the life of the patient, ocular involvement is often missed and a significant proportion of patients present to an ophthalmologist with the chronic ocular sequelae. In India, chronic ocular sequelae and low vision are observed in two-thirds of patients who present in the chronic phase of SJS/TEN. In the chronic phase of ocular involvement, there are definite windows of opportunity which if targeted with specific interventions such as scleral lenses and mucous membrane grafts can help reduce the incidence of corneal blindness and improve the quality of life for patients with SJS/TEN. Over the last decade, several studies from India have advanced the understanding of the natural course of ocular involvement in SJS/TEN and the outcomes of timely interventions in the chronic phase of the disease. We present an overview of the epidemiology of ocular complications of SJS/TEN in India, the specific challenges faced in the management of ocular complications in the acute stage and recent advances in management of the chronic ocular complications of the disease.

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Section: Keratoprosthesis In Sjs/tenmentioning

confidence: 99%

Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

et al. 2021

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“…But what happens in BKPro II eyes? Another idea that encouraged us to perform TSCPC is that despite other authors describing the placement of an Ahmed valve when preoperatory glaucoma is detected in BKPro II [ 16 , 17 ], we have doubts about the drainage function of this valve in the absence of conjunctiva. Specifically, the subconjunctival space collapses after a BKPro II implant, and the corresponding structure is completely removed; subsequently, the Ahmed plate is in direct contact with the eyelid tissues which have a notably different tension and rigidity to those of the conjunctiva.…”

Section: Discussionmentioning

confidence: 99%

Transscleral Cyclophotocoagulation for the Treatment of Uncontrolled Glaucoma in a Boston Keratoprosthesis Type II Patient

Larrea

Črnej²,

Soto

et al. 2022

Case Rep Ophthalmol

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Postoperative endoscopic cyclophotocoagulation (CPC) for the treatment of glaucoma in patients with Boston keratoprosthesis type II (BKPro II) was first described in 2017 by Poon et al. (<i>Endoscopic cyclophotocoagulation for the treatment of glaucoma in Boston keratoprosthesis type ii patient. J Glaucoma. 2017 Apr;26(4):e146–9</i>). As we do not have this device, we present a case of transscleral CPC (TSCPC), in a BKPro II patient who had graft versus host disease and developed uncontrolled glaucoma. We dissected plane by plane to expose the bare sclera and performed the procedure as traditionally described. We concluded that this is a safe, controlled, and effective option in this patient population where the glaucoma treatment options are very limited. To the best of our knowledge, this is the first case report to describe the surgical technique of TSCPC in a BKPro II patient.

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“…A patient diagnosed of SJS/TEN should promptly be taken to the hospital because it could endanger their lives (Iyer et al, 2019). The nature of the condition can be easily assessed whether the diagnosis is confirmed so as to determine the best place of care.…”

Section: Treatmentmentioning

confidence: 99%

Stevens - Johnson Syndrome: A Short Review

Ashok¹,

Babu²,

Sumathi³

et al. 2021

IJZI

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The syndrome of Stevens-Johnson (SJS) and toxic epidermal necrolysis (TEN) are serious, mostly medicated, cutaneous adverse reactions, normally linked to a high degree of morbidity and mortality. Recently, the SJS/TEN management guidance, the Indian guidelines and the United Kingdom directives have been written in details. However, there is no agreement on SJS/TEN management. In this paper, we would like to conceptualise SJS/TEN system in order of Indian schedule. It has been found useful to discontinue all drugs early, take help steps (hydration, electrolytes, and skin care denuded), corticosteroids, and cyclosporine. Oral provocation tests are only available to those receiving full remission that are strictly attentive during hospitalisation. As there is no majority, care on an individual basis should be personalised.

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Boston Type 2 keratoprosthesis- mid term outcomes from a tertiary eye care centre in India

Cited by 28 publications

References 9 publications

Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

Transscleral Cyclophotocoagulation for the Treatment of Uncontrolled Glaucoma in a Boston Keratoprosthesis Type II Patient

Stevens - Johnson Syndrome: A Short Review

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