Retroprosthetic membrane: A complication of keratoprosthesis with broad consequences

Park, Jennifer; Phrueksaudomchai, Pakornkit; Cortina, María Soledad

doi:10.1016/j.jtos.2020.09.004

Cited by 24 publications

(15 citation statements)

References 43 publications

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“…Therefore, drugs that target MMP-9 might be able to decrease RPM formation. 40,41 Glaucoma, another of the postoperative challenges, can lead to significant visual loss. In the current study, 37% of the eyes showed further progression of glaucoma.…”

Section: Discussionmentioning

confidence: 99%

Long-term Outcomes of Boston Type I Keratoprosthesis, and Efficacy of Amphotericin B and Povidone-Iodine in Infection Prophylaxis

Prabhasawat

Chotikavanich

Ngowyutagon

et al. 2021

American Journal of Ophthalmology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionmentioning

confidence: 99%

Long-term Outcomes of Boston Type I Keratoprosthesis, and Efficacy of Amphotericin B and Povidone-Iodine in Infection Prophylaxis

Prabhasawat

Chotikavanich

Ngowyutagon

et al. 2021

American Journal of Ophthalmology

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“…It is believed that the initial indication for corneal replacement surgery relates to the development of RPM. 15 Indeed, in a large multicentric study by Rudnisky et al the strongest risk factor for RPM development was infectious keratitis [Hazard Ratio (HR): 3.20; P = 0.0005]. Aniridia was also believed to be associated with an increased risk of RPM (HR: 3.13, P = 0.069).…”

Section: Discussionmentioning

confidence: 99%

Retroprosthetic Membrane Formation in Boston Keratoprosthesis Type 1: Incidence, Predisposing Factors, Complications, and Treatment

Khair

Daoud²,

Harissi‐Dagher³

2021

Cornea

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The purpose of this study was to evaluate the incidence, rate of formation, and risk factors of retroprosthetic membrane (RPM) after Boston type 1 keratoprosthesis (BKPro) as well as identify secondary complications linked to its formation and describe its treatment.Methods: This was a retrospective cohort study. One hundred thirty-three eyes of 115 patients who underwent BKPro implantation at the Centre Hospitalier de l'Université de Montréal from 2008 to 2017 were included with at least 1-year follow-up. Charts were reviewed, and data were collected, including incidence of RPM formation, preoperative and intraoperative risk factors, postoperative complications, and treatment modalities. Results:The mean follow-up was 5.5 years, and 39% (n = 52) of eyes developed RPM. No etiologies were found to be significantly associated with RPM development. Simultaneous lensectomy and simultaneous intraocular lens extraction were respectively positively and negatively correlated with RPM development [odds ratio (OR): 0.3590, 95% CI: 0.1629-0.7570, P = 0.0097; OR = 2.646, 95% CI: 1.273-5.585, P = 0.0086, respectively]. As for postoperative complications, the strongest correlation was between RPM and retinal detachment (OR = 6.16, 95% CI: 2.14-16.14; P = 0.0004). RPM development was also positively associated with the development of hypotony and corneal melt. Nd:YAG membranectomy was the most common treatment, performed in 83% of eyes with RPM (n = 24), with 58% resolution.Conclusions: More than one third of patients who undergo BKPro will develop RPM, requiring close monitoring for retinal detachment. Simultaneous intraocular lens extraction seems protective, whereas simultaneous lens extraction increases the rate of RPM formation significantly. Nd:YAG membranectomy can be used as an initial noninvasive approach.

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“…There are conflicting reports about whether titanium can cause a reduction in retroprosthetic membrane (RPM) formation, which occurs when fibrovascular tissue grows behind the device. Up to 65% of patients with a Boston KPro form an RPM ( 56 ). A study by Todani et al ( 57 ) investigated the potential for RPM formation in 55 eyes with PMMA backplates and 23 with titanium backplates: 41.8% of patients with PMMA backplates developed RPM compared to only 13% for patients with titanium backplates at 6 months post-implantation.…”

Section: Hard Keratoprosthesesmentioning

confidence: 99%

Artificial Cornea: Past, Current, and Future Directions

et al. 2021

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Corneal diseases are a leading cause of blindness with an estimated 10 million patients diagnosed with bilateral corneal blindness worldwide. Corneal transplantation is highly successful in low-risk patients with corneal blindness but often fails those with high-risk indications such as recurrent or chronic inflammatory disorders, history of glaucoma and herpetic infections, and those with neovascularisation of the host bed. Moreover, the need for donor corneas greatly exceeds the supply, especially in disadvantaged countries. Therefore, artificial and bio-mimetic corneas have been investigated for patients with indications that result in keratoplasty failure. Two long-lasting keratoprostheses with different indications, the Boston type-1 keratoprostheses and osteo-odonto-keratoprostheses have been adapted to minimise complications that have arisen over time. However, both utilise either autologous tissue or an allograft cornea to increase biointegration. To step away from the need for donor material, synthetic keratoprostheses with soft skirts have been introduced to increase biointegration between the device and native tissue. The AlphaCor™, a synthetic polymer (PHEMA) hydrogel, addressed certain complications of the previous versions of keratoprostheses but resulted in stromal melting and optic deposition. Efforts are being made towards creating synthetic keratoprostheses that emulate native corneas by the inclusion of biomolecules that support enhanced biointegration of the implant while reducing stromal melting and optic deposition. The field continues to shift towards more advanced bioengineering approaches to form replacement corneas. Certain biomolecules such as collagen are being investigated to create corneal substitutes, which can be used as the basis for bio-inks in 3D corneal bioprinting. Alternatively, decellularised corneas from mammalian sources have shown potential in replicating both the corneal composition and fibril architecture. This review will discuss the limitations of keratoplasty, milestones in the history of artificial corneal development, advancements in current artificial corneas, and future possibilities in this field.

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Retroprosthetic membrane: A complication of keratoprosthesis with broad consequences

Cited by 24 publications

References 43 publications

Long-term Outcomes of Boston Type I Keratoprosthesis, and Efficacy of Amphotericin B and Povidone-Iodine in Infection Prophylaxis

Long-term Outcomes of Boston Type I Keratoprosthesis, and Efficacy of Amphotericin B and Povidone-Iodine in Infection Prophylaxis

Retroprosthetic Membrane Formation in Boston Keratoprosthesis Type 1: Incidence, Predisposing Factors, Complications, and Treatment

Artificial Cornea: Past, Current, and Future Directions

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