Introduction to the use of the Boston keratoprosthesis

Dohlman, Claes H.; Harissi‐Dagher, Mona; Khan, Bilal; Sippel, Kimberly C.; Aquavella, James V.; Graney, John

doi:10.1586/17469899.1.1.41

Cited by 94 publications

(54 citation statements)

References 16 publications

(19 reference statements)

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“…16 As seen in Figures 1 and 2, it is a collar button shaped polymethylmethacrylate device consisting of two curved plates that is implanted through the eyelids in severe dry eye and cicatricial diseases. Type II Boston KPro is performed far less than type I, and is reserved for near-hopeless cases with severe destruction of the ocular surface.…”

Section: Boston Kpro Type IImentioning

confidence: 99%

Cost effectiveness of the type II Boston keratoprosthesis

Ament

Stryjewski

Pujari

et al. 2010

Eye

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Purpose Despite demonstrated cost effectiveness, not all corneal disorders are amenable to type I Boston keratoprosthesis (KPro) implantation. This includes patients with autoimmune diseases, such as Stevens-Johnson syndrome/toxic epidermal necrolysis. Type II KPro is implanted through the eyelids in severe dry eye and cicatricial diseases, and its cost effectiveness was sought.Patients and methods In a retrospective chart review, 29 patients who underwent type II KPro surgery at the Massachusetts Eye and Ear Infirmary between the years 2000 and 2009 were identified. A total of 11 patients had 5-year follow-up data. Average cost effectiveness was determined by cost-utility analysis, comparing type II KPro surgery with no further intervention. Results Using the current parameters, the cost utility of KPro from third-party insurer (Medicare) perspective was 63 196 $/qualityadjusted life year. Conclusion Efforts to refer those less likely to benefit from traditional corneal transplantation or type I KPro, for type II KPro surgery, may decrease both patient and societal costs.

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Section: Boston Kpro Type IImentioning

confidence: 99%

Cost effectiveness of the type II Boston keratoprosthesis

Ament

Stryjewski

Pujari

et al. 2010

Eye

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“…Life-long topical steroids is necessary in all KPro eyes to prevent inflammation. 10,14 Also, the addition of 5% povidone iodine washes were added in each checkup with patients having high risk of endophthalmitis as well as those with a single eye, self-immune diseases or previous endophthalmitis history.…”

mentioning

confidence: 99%

Boston keratoprosthesis type 1 - indication, complication and visual outcomes

Raina

Gupta

2017

Int J Res Med Sci

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Background: Diseases affecting the cornea are a major cause of blindness all over the world, second only to cataract in overall importance. In India, there are approximately 6.8 million people who have corneal blindness with vision less than 6/60 in at least one eye, and of these, about 1 million have bilateral corneal blindness.Methods: The study was conducted in upgraded department of ophthalmology, L.L.R.M. Medical College, Meerut, India from January 2014 to June 2015. It was prospective interventional study. Included those patients who have Failed corneal graft with poor prognosis for further grafting, multiple corneal graft failure, having nearly total corneal neovascularization, vision less than 6/60 with associated other complications in better eye and no vision in opposite eye and Healed Chemical burn and those patients who has end stage glaucoma or RD (retinal detachment), defective perceptions and projection of light and not willing for the procedure.Results: A total of 20 patients were enrolled for the study which were followed up and assessed over 12 months. It was observed that maximum number of patients were in the age group of 41-60 years (45%) and in the >60 years group are minimum (20%). Among these 14 cases (70%) were male and 6 cases (30%) were female.Conclusions: The Boston type 1 keratoprosthesis provides visual recovery for eyes with multiple PK failures or with poor prognosis for primary PK, showing excellent retention rates. Most of the cases had a significant improvement in vision after Boston type I KPro implantation.

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“…The Boston Type I Keratoprosthesis has become the most common procedure for cases where standard keratoplasty has failed (6) . Multicenter and medium term outcome studies have been encouraging (7) .…”

mentioning

confidence: 99%

“…Long-term complications associated with the device include glaucoma, retroprosthetic membrane formation, sterile vitritis, retinal detachment and, now rarely, endophthalmitis (9) . A Type II device with an extended nub that protrudes a closed lid is occasionally used in end-stage dry eyes (6) . Boston Keratoprosthesis implantation has been proven to be a highly cost-effective medical intervention in the US (10) .…”

mentioning

confidence: 99%