American journal of ophthalmology · 2014
Outcomes following Boston type 1 keratoprosthesis implantation in aniridia patients at the University of Montreal.
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Hassanaly Salima I, Talajic Julia C, Harissi-Dagher Mona
Аннотация
PURPOSE: To describe outcomes after Boston Type 1 Keratoprosthesis (KPro) surgery in aniridic eyes.
DESIGN: Retrospective, interventional case series.
SETTING: University-based tertiary care institution.
PATIENT POPULATION: Twenty-six aniridic eyes of 19 patients who underwent KPro implantation by a single experienced surgeon (M.H.-D.) between October 27, 2008 and January 16, 2012.
MAIN OUTCOME MEASURES: Preoperative and postoperative best-corrected visual acuity (BCVA), intraoperative and postoperative complications, and keratoprosthesis retention.
RESULTS: Mean age was 56 years (range, 28-72); 10 patients were male. Seven patients had bilateral procedures. No intraoperative complications were encountered. Preoperatively, BCVA was 20/300 or worse in all eyes. After a mean follow-up time of 28.7±13.5 months (range 4-50), the most recent BCVA was 20/200 or better in 14 eyes. Visual potential was limited by preexisting terminal glaucoma (n=2), phthisis after retinal detachment (n=4), and suprachoroidal hemorrhage (n=2). Other postoperative complications included retroprosthetic membrane formation (n=15), infectious keratitis (n=1), extrusion (n=2), and corneal melt (n=4). Uncomplicated vitritis was reported in 6 eyes. No endophthalmitis occurred in this series. Most eyes have glaucoma and are on medical treatment. The overall retention rate of the initial prosthesis was 77%.
CONCLUSIONS: The prognosis in aniridic patients after KPro is variable. Meticulous follow-up and a subspecialty team approach are of utmost importance.
DESIGN: Retrospective, interventional case series.
SETTING: University-based tertiary care institution.
PATIENT POPULATION: Twenty-six aniridic eyes of 19 patients who underwent KPro implantation by a single experienced surgeon (M.H.-D.) between October 27, 2008 and January 16, 2012.
MAIN OUTCOME MEASURES: Preoperative and postoperative best-corrected visual acuity (BCVA), intraoperative and postoperative complications, and keratoprosthesis retention.
RESULTS: Mean age was 56 years (range, 28-72); 10 patients were male. Seven patients had bilateral procedures. No intraoperative complications were encountered. Preoperatively, BCVA was 20/300 or worse in all eyes. After a mean follow-up time of 28.7±13.5 months (range 4-50), the most recent BCVA was 20/200 or better in 14 eyes. Visual potential was limited by preexisting terminal glaucoma (n=2), phthisis after retinal detachment (n=4), and suprachoroidal hemorrhage (n=2). Other postoperative complications included retroprosthetic membrane formation (n=15), infectious keratitis (n=1), extrusion (n=2), and corneal melt (n=4). Uncomplicated vitritis was reported in 6 eyes. No endophthalmitis occurred in this series. Most eyes have glaucoma and are on medical treatment. The overall retention rate of the initial prosthesis was 77%.
CONCLUSIONS: The prognosis in aniridic patients after KPro is variable. Meticulous follow-up and a subspecialty team approach are of utmost importance.