Outcomes of Boston Keratoprosthesis Implantation for Failed Keratoplasty After Keratolimbal Allograft

Hou, Joshua H.; Cruz, José de la; Djalilian, Ali R.

doi:10.1097/ico.0b013e31823e2ac6

Cited by 25 publications

(14 citation statements)

References 17 publications

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“…Artificial corneas undoubtedly can improve vision but should be considered in cases when PKP has failed or expected to fail (e.g., in the setting of extensive stromal vascularization) [121–126]. Currently, the Boston keratoprosthesis remains the main option in patients in which it has not been possible to restore corneal clarity and a normal ocular surface with any of previous measures [121, 127].…”

Section: Surgical Managementmentioning

confidence: 99%

“…Currently, the Boston keratoprosthesis remains the main option in patients in which it has not been possible to restore corneal clarity and a normal ocular surface with any of previous measures [121, 127]. Their long-term risks, the need for life-long regular followups, and adherence to daily antibiotic prophylaxis are some of the issues that may make some patients less than ideal candidates for keratoprosthesis [122, 124, 125].…”

Section: Surgical Managementmentioning

confidence: 99%

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The Ocular Surface Chemical Burns

Eslani

Baradaran‐Rafii

Movahedan

et al. 2014

Journal of Ophthalmology

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132

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Ocular chemical burns are common and serious ocular emergencies that require immediate and intensive evaluation and care. The victims of such incidents are usually young, and therefore loss of vision and disfigurement could dramatically affect their lives. The clinical course can be divided into immediate, acute, early, and late reparative phases. The degree of limbal, corneal, and conjunctival involvement at the time of injury is critically associated with prognosis. The treatment starts with simple but vision saving steps and is continued with complicated surgical procedures later in the course of the disease. The goal of treatment is to restore the normal ocular surface anatomy and function. Limbal stem cell transplantation, amniotic membrane transplantation, and ultimately keratoprosthesis may be indicated depending on the patients' needs.

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Section: Surgical Managementmentioning

confidence: 99%

Section: Surgical Managementmentioning

confidence: 99%

The Ocular Surface Chemical Burns

Eslani

Baradaran‐Rafii

Movahedan

et al. 2014

Journal of Ophthalmology

Self Cite

132

View full text Add to dashboard Cite

show abstract

“…159–164 Currently, the Boston Type 1 keratoprosthesis ( B1-KPro ) is the most widely used device for restoring vision in patients who have failed previous corneal procedures. 159,165 Placement of a keratoprosthesis with or without a shunt may be considered 6 months after inflammation subsides (Figure 11). 106,166 The B1-KPro study group found excellent anatomical retention in patients with ocular chemical injuries: 94% after 1 year and 89% after 2 years.…”

Section: Management Of Chronic Phasementioning

confidence: 99%

Current and Upcoming Therapies for Ocular Surface Chemical Injuries

et al. 2017

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Chemical injuries frequently result in vision loss, disfigurement, and challenging ocular surface complications. Acute interventions are directed at decreasing the extent of the injury, suppressing inflammation, and promoting ocular surface re-epithelialization. Chronically, management involves controlling inflammation along with rehabilitation and reconstruction of the ocular surface. Future therapies aimed at inhibiting neovascularization and promoting ocular surface regeneration should provide more effective treatment options for the management of ocular chemical injuries.

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“…For unilateral disease, conjunctival limbal autograft may be the best option. For bilateral disease, allogeneic tissues are needed as stem cell sources [3,[8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of Allogeneic Ocular Surface Reconstruction: Keratolimbal Allograft (KLAL) Followed by Penetrating Keratoplasty (PK)

Krysik¹,

Dobrowolski

Tarnawska

et al. 2020

Journal of Ophthalmology

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Purpose. Long-term results of the patients with total LSCD, who had undergone keratolimbal allograft (KLAL) for limbal reconstruction followed by penetrating keratoplasty (PK). Methods. The study analyzes surgical treatment of 43 eyes with severe ocular surface disorders. All subjects underwent KLAL to achieve suitable conditions for consecutive PK. Due to failures of primary treatment in 17 eyes (39%), the KLAL was repeated. PK was performed in all the patients at 9-12 months after KLAL. As a retrospective study we analyzed data from the medical records including the preoperative and postoperative best corrected visual acuity, corneal clarity, surgical outcomes and complications, postoperative intraocular pressure, graft rejection, and other comorbidities and complications. Results. The preoperative visual acuity ranged from light perception to 0.01. The final improvement of visual acuity within a gain of one or more lines with the Snellen chart, including the results of successive surgical treatments after PK, was achieved in 23 operated eyes (53%). Early graft rejection was observed in 4 eyes (9%). In 3 eyes, it was manifested as endothelial rejection, and in 1 eye, as combined endothelial and epithelial rejection. PK failure requiring repetitive PK was present in 14 eyes (32%). Phthisis bulbi developed in 6 eyes (14%). Glaucoma or ocular hypertension was reported in 25 eyes (58%). A majority were treated with up to 3 topical agents or referred for trabeculectomy in 3 cases, transscleral cyclophotocoagulation in 2 eyes, and EX-PRESS glaucoma shunt implantation in 3 cases. Conclusions. Successful KLAL carries a high risk of subsequent PK failure. Visual function remains the second aim of treatment; the primary one is to stabilize the surface.

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Outcomes of Boston Keratoprosthesis Implantation for Failed Keratoplasty After Keratolimbal Allograft

Cited by 25 publications

References 17 publications

The Ocular Surface Chemical Burns

The Ocular Surface Chemical Burns

Current and Upcoming Therapies for Ocular Surface Chemical Injuries

Long-Term Outcomes of Allogeneic Ocular Surface Reconstruction: Keratolimbal Allograft (KLAL) Followed by Penetrating Keratoplasty (PK)

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