Long-term outcomes of the Boston type I keratoprosthesis in eyes with previous herpes simplex virus keratitis

Fry, Melinda; Aravena, Carolina; Yu, Fei; Kattan, Jaffer M.; Aldave, Anthony J.

doi:10.1136/bjophthalmol-2017-310186

Cited by 12 publications

(6 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To the best of our knowledge, there were no studies about these engineered corneal tissues regarding HSK patients except for three studies which reported the long‐term outcomes of the Boston type I Kpro in eyes with a history of HSV keratitis. The postoperative complications such as persistent epithelial defect, corneal infiltrate were approximately twice of those without HSV infection …”

Section: Discussionmentioning

confidence: 97%

“…The pathogenesis of corneal graft melting is complex and infection and immune response play a key role. Previous studies have shown HSK patients undergoing LKP are at higher risk for graft failure when compared to individuals received keratoplasty for conditions such as keratoconus and Fuchs’ corneal dystrophy, which often require repeated grafting . Timely recognition and management is required to prevent the recurrence of HSV‐related inflammation and graft rejection.…”

Section: Discussionmentioning

confidence: 99%

“…phy, which often require repeated grafting. 21,23 Timely recognition and management is required to prevent the recurrence of…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Short‐term results of acellular porcine corneal stroma keratoplasty for herpes simplex keratitis

Zheng

Huang

Zhang

et al. 2019

Xenotransplantation

View full text Add to dashboard Cite

Background Corneal transplantation is a common surgical intervention for restoring vision loss due to corneal damages. However, for cultural reasons, there is a huge shortage of donor corneas in China. Acellular porcine corneal stromas (APCSs) can be used as corneal substitutes in lamellar keratoplasty for corneal ulcers. This study was conducted to analyze the results of APCS use for herpes simplex keratitis (HSK). Methods The study involved HSK patients who underwent keratoplasty with APCSs from February 2016 to October 2017 in the second affiliated hospital of Zhejiang University. Patient data were collected at 7 days, 1 month, 3 months, 6 months, and at the last follow‐up (7‐25 months) postoperative. The corneal transparency, neovascularization, visual acuity, and graft stability were observed. Results Thirteen patients with HSK including five patients with corneal perforation were included in this study, nine patients underwent deep anterior lamellar keratoplasty (DALK) and five perforation patients underwent double lamellar keratoplasty. There were nine men and four women with an average age of 62.5 ± 5.6 years old (ranging from 52 to 70 years old). The mean postoperative follow‐up duration was 15.1 ± 5.8 months (ranging from 7 to 25 months). At the last visit, visual acuity improved in nine patients (69.2%) compared with preoperative (P = 0.008).The grafts of seven individuals (53.8%) were completely transparent or slightly opaque; their corneal transparency score had improved significantly compared with before the surgery (P = 0.010). Various degrees of neovascularization were present in 11 of the 13 patients (84.6%), most neovascularization gradually stabilized. Graft dissolution occurred in three eyes (23.1%) during the observation period, two underwent regrafting, the other one became stable after treatment. Three patients underwent second allograft transplantation, two of which encountered APCS graft dissolution and one of the patients requested a human donor allograft transplantation due to transparency issues despite the absence of adverse issues. Conclusion Acellular porcine corneal stroma seems to be effective in the treatment of HSK and can be used in HSK with corneal perforation by using double lamellar keratoplasty in an emergency.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Short‐term results of acellular porcine corneal stroma keratoplasty for herpes simplex keratitis

Zheng

Huang

Zhang

et al. 2019

Xenotransplantation

View full text Add to dashboard Cite

show abstract

“…44,50 Finally, Fry and colleagues reported 60% of the eyes with BCVA of 20/200 or better at 3 years in patients with herpes simplex keratitis. 48 In contrast, patients with herpes zoster infection achieved BCVA ≥20/200 only in 25% of eyes. 47…”

Section: Visual Outcomesmentioning

confidence: 97%

“…In comparison, retention in eyes with nonautoimmune forms of LSCD was better, ranging from 64% to 100% at last follow-up. 39,40,48,49,52 Of note, the two studies reporting 100% retention in chemical injury, had an incidence of KPro replacement of 10% and 22%. Interestingly, more than 70% of eyes had previous surface surgery, including limbal stem cell transplantation or mucous membrane grafting highlighting that preparation of the ocular surface in severely compromised eyes is an important step that increases keratoprosthesis success.…”

Section: Anatomical Retentionmentioning

confidence: 98%

<p>Boston Type 1 Keratoprosthesis: Updated Perspectives</p>

Nonpassopon¹,

Niparugs²,

Cortina³

2020

OPTH

View full text Add to dashboard Cite

The use of Boston type 1 keratoprosthesis (BKPro) has significantly increased worldwide. It is no longer considered a procedure of last resort but a reasonable option for patients with otherwise poor prognosis for a traditional penetrating keratoplasty. BKPro was approved by the Food and Drug Administration in 1992 for bilateral severe corneal blindness due to multiple corneal transplant failure. Over the years, indications have extended beyond recurrent immunologic rejection to include other conditions such as chemical injury and other causes of bilateral limbal stem cell deficiency, extensive corneal neovascularization, neurotrophic corneas and hypotony, among others. Numerous advances in the design of the BKPro, improvement of preoperative, intraoperative and postoperative management have resulted in favorable outcomes and a reduction in postoperative complications. Accordingly, many studies have shown that implantation of this device is highly effective in restoring vision with very good short-term outcomes. However, due to the lifetime risk of sight-threatening complications after BKPro implantation, a longer follow-up period should provide outcomes that are more realistic. In this review, the authors examined only the results of publications with an average of at least 2 years of follow-up. The overall intermediate to long-term visual outcomes and retention rate in BKPro seem to be favorable. However, autoimmune diseases and cicatrizing conditions continue to show a higher incidence of postoperative complications that require further management.

show abstract

Nanoparticles for Cornea Therapeutic Applications: Treating Herpes Simplex Viral Infections

Simpson

Gueriot

Brunette

et al. 2019

Nanoengineering Materials for Biomedical Uses

View full text Add to dashboard Cite

Long-term outcomes of the Boston type I keratoprosthesis in eyes with previous herpes simplex virus keratitis

Cited by 12 publications

References 25 publications

Short‐term results of acellular porcine corneal stroma keratoplasty for herpes simplex keratitis

Short‐term results of acellular porcine corneal stroma keratoplasty for herpes simplex keratitis

<p>Boston Type 1 Keratoprosthesis: Updated Perspectives</p>

Nanoparticles for Cornea Therapeutic Applications: Treating Herpes Simplex Viral Infections

Contact Info

Product

Resources

About