Longer-Term Vision Outcomes and Complications with the Boston Type 1 Keratoprosthesis at the University of California, Davis

Greiner, Mark A.; Li, Jennifer Y.; Mannis, Mark J.

doi:10.1016/j.ophtha.2010.12.032

Cited by 186 publications

(157 citation statements)

References 21 publications

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“…Using the same VA criterion (0.05), Verdejo-Gomez et al [16] found a success rate of 83% (n = 12). Using 0.10 VA, but with different follow-up times, Greiner et al [14 ]had success in 89% (n = 36 at 1 year), Bradley et al [4] in 77% (n = 30), Aldave et al [17] in 68% (n = 27 at 1 year), Goldman et al [18] in 63% (n = 107), Zerbe et al [12 ]in 57% (n = 141) and Patel et al [19] in 43% (n = 50) of cases. This shows that our VA success rate is consistent with previous reports.…”

Section: Discussionmentioning

confidence: 99%

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Influence of Primary Diagnosis and Complications on Visual Outcome in Patients Receiving a Boston Type 1 Keratoprosthesis

Nascimento

Paz²,

Rosandic³

et al. 2014

Ophthalmic Res

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Purpose: To analyse how primary diagnosis and complications affect the evolution of post-operative visual acuity (VA). Methods: We performed retrospective chart analysis on 59 eyes in 57 patients with various diagnoses, most of which were non-standard indications for Boston type 1 keratoprosthesis (Kpro) implantation. The follow-up period was at least 3 months. Patients were classified based on the evolution of post-operative VA: group A demonstrated stable VA improvement, group B lost VA improvement and group C no significant VA improvement. Results: We assigned 46% of our cases to group A with stable VA improvement, 32% to group B with lost VA improvement, and 22% to group C with no VA improvement. The number of graft failures before Kpro implantation did not influence VA outcome. Except for the relatively good VA outcome in chemical burn and radiation injury patients, there seems to be no association between primary diagnosis and positive or negative VA outcome. Only 9% of patients with posterior segment complications and 20% with infections and associated pathologies were assigned to group A. Conclusion: Most cases (78%) showed improvement in VA after Boston type 1 Kpro (groups A and B). Posterior segment complications and infections mostly resulted in persistent loss of vision. These complications should be prevented and carefully treated.

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Section: Discussionmentioning

confidence: 99%

“…The post-operative standard treatment regimen was ofloxacin or tobramycin, vancomycin 14 mg/ml and prednisolone acetate 1% [12,13,14]. Other medications were administered based on clinical needs.…”

Section: Methodsmentioning

confidence: 99%

Influence of Primary Diagnosis and Complications on Visual Outcome in Patients Receiving a Boston Type 1 Keratoprosthesis

Nascimento

Paz²,

Rosandic³

et al. 2014

Ophthalmic Res

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“…Three patients (10%) had endophthalmitis despite the correct use of postoperative medications (including 1.4% vancomycin eye drops). At the same center, in a longer followup, Greiner et al (41) , found that a significant number of patients can decrease vision during the postoperative course. Endstage glaucoma was the most commonly cause of visual loss when best corrected visual acuity (BCVA) > 20/200 was not retained.…”

Section: Resultsmentioning

confidence: 96%

Boston type I keratoprosthesis: Review

Magalhães

Sousa

Oliveira

2012

Arq. Bras. Oftalmol.

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Regardless of significant progress in the field of corneal transplantation to treat cor neal opacification, some cases of corneal blindness still present a poor prognosis for conventional penetrating keratoplasty. In patients with repeated graft fai lure and/or with severe ocular surface disease, the Boston type I keratoprosthesis (type I BKPro) has become a viable option. Modifications in its design and postoperative management have improved the longterm outcomes of visual acuity, retention, and postoperative infection rates. These advances made the type I BKPro be considered a safe alternative for visual rehabilitation in many patients with corneal pathologies. However, postoperative handle of chronic comorbidities, such as glaucoma, is still critical for preserving the visual gains achieved with BKPro.

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“…Dabei ist bezüglich der Kontaktlinse nicht nur der mechanische Schutz des Interface und des Epithels von Bedeutung, sondern auch eine Speicherwirkung für das Antibiotikum [5,7,8,9,10,19,22]. Die Ergebnisse der hier vorgestellten Serie sind bezüglich Funktion, Komplikationen und Retention vergleichsweise positiv, wobei der noch verhältnismäßig kurze Nachbeobachtungszeitraum diese Aussage relativiert [1].…”

Section: Diskussionunclassified

“…Die Ergebnisse der hier vorgestellten Serie sind bezüglich Funktion, Komplikationen und Retention vergleichsweise positiv, wobei der noch verhältnismäßig kurze Nachbeobachtungszeitraum diese Aussage relativiert [1]. Schwere Komplikationen wie eine Endophthalmitis, über die in 0-12,5% der Fälle berichtet wird, wurden in unserer Serie bisher nicht beobachtet [1,3,4,9,19,26]. Generell gilt das Risiko einer Endophthalmitis bei der BKP als im Vergleich zu anderen Systemen wie der Osteoodontokeratoprothese (OOKP) als erhöht, da es im Gegensatz hierzu keine mit natürlichem Gewebe ausgekleidete Barriere in das Innere des Auges gibt [12,13].…”

Section: Diskussionunclassified