TY - JOUR
T1 - Long-term outcomes of the aphakic snap-on Boston type I keratoprosthesis at the bascom palmer eye institute
AU - Gibbons, Allister
AU - Leung, Ella H.
AU - Haddock, Luis J.
AU - Medina, Carlos A.
AU - Fernandez, Viviana
AU - Parel, Jean Marie A.
AU - Durkee, Heather A.
AU - Amescua, Guillermo
AU - Alfonso, Eduardo C.
AU - Perez, Victor L.
N1 - Funding Information:
We are indebted to Tayyeba K Ali, MD, for her knowledge, hard work, and guidance during the course of the research. This research was supported by the Florida Lions Eye Bank, NEI Core Grant (EY0,14,801), Research to Prevent Blindness Unrestricted Grant, Department of Defense (DOD, Grant# W81XWH-09–1-0675 and Grant# W81XWH-13–1-0048 ONOVA) (institutional), the Henri and Flore Lesieur Foundation (JMP); and Walter G Ross Chair in Ophthalmic Research (VLP).
Publisher Copyright:
© 2018 Gibbons et al.
PY - 2018/2/15
Y1 - 2018/2/15
N2 - Purpose: To determine the indications, long-term clinical and visual outcomes, and complications of the aphakic snap-on type I Boston keratoprosthesis (KPro). Design: Retrospective, non-comparative case series. Methods: Forty-five eyes of 43 patients with type I aphakic snap-on KPros with at least 1 year of follow-up were included. The past medical histories, preoperative indications, best-corrected visual acuities (BCVAs), postoperative complications, and retention rates were analyzed. Results: The most common indication for KPro implantation was a failed corneal graft (89%). The mean preoperative BCVA was count fingers–hand motion (2.14±0.45 logarithm of minimum angle of resolution [logMAR]), which initially improved to 20/200 (1.04±0.85 logMAR; P<0.0001). At the last examination, 24 eyes (53%) maintained some visual gain, 22% retained their preoperative visual acuity, and 24% lost vision due to postoperative events and underlying ocular comorbidities. Postoperative complications included retroprosthetic membranes (8/45, 18%), corneal melts (5/45, 11%), glaucoma progression (6/45, 13%), and endophthalmitis or sterile vitritis (6/45, 13%). The KPro retention rate was 89%, with a mean follow-up of 51 months. The mean BCVA at the last visit was 20/1,400 (1.82±0.92 logMAR). Conclusion: Most patients experienced improved visual acuity after the implantation of the aphakic, snap-on type I KPro; however, the visual gains were not sustained over time, correlating with the onset of postoperative complications.
AB - Purpose: To determine the indications, long-term clinical and visual outcomes, and complications of the aphakic snap-on type I Boston keratoprosthesis (KPro). Design: Retrospective, non-comparative case series. Methods: Forty-five eyes of 43 patients with type I aphakic snap-on KPros with at least 1 year of follow-up were included. The past medical histories, preoperative indications, best-corrected visual acuities (BCVAs), postoperative complications, and retention rates were analyzed. Results: The most common indication for KPro implantation was a failed corneal graft (89%). The mean preoperative BCVA was count fingers–hand motion (2.14±0.45 logarithm of minimum angle of resolution [logMAR]), which initially improved to 20/200 (1.04±0.85 logMAR; P<0.0001). At the last examination, 24 eyes (53%) maintained some visual gain, 22% retained their preoperative visual acuity, and 24% lost vision due to postoperative events and underlying ocular comorbidities. Postoperative complications included retroprosthetic membranes (8/45, 18%), corneal melts (5/45, 11%), glaucoma progression (6/45, 13%), and endophthalmitis or sterile vitritis (6/45, 13%). The KPro retention rate was 89%, with a mean follow-up of 51 months. The mean BCVA at the last visit was 20/1,400 (1.82±0.92 logMAR). Conclusion: Most patients experienced improved visual acuity after the implantation of the aphakic, snap-on type I KPro; however, the visual gains were not sustained over time, correlating with the onset of postoperative complications.
KW - Aphakia
KW - Corneal blindness
KW - Keratoprosthesis
KW - Penetrating keratoplasty
KW - Snap-on type I keratoprosthesis
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U2 - 10.2147/OPTH.S144403
DO - 10.2147/OPTH.S144403
M3 - Article
AN - SCOPUS:85042362189
VL - 12
SP - 331
EP - 337
JO - Clinical Ophthalmology
JF - Clinical Ophthalmology
SN - 1177-5467
ER -