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Boston keratoprosthesis

Asim V Farooq, Joshua H Hou, Sarmad Jassim, Zeeshan Haq, Elmer Y Tu, Jose de la Cruz, Maria S Cortina
OBJECTIVES: To determine the rate of biofilm formation on bandage contact lenses worn by patients with the Boston type 1 keratoprosthesis (K-Pro) while on prophylactic topical vancomycin versus linezolid. METHODS: Patients wearing a bandage contact lens (BCL) with a K-Pro were eligible for enrollment. After irrigation of the ocular surface with 5% povidone-iodine solution, each patient was placed on either topical vancomycin 15 mg/mL or linezolid 0.2% BID for one month...
October 13, 2016: Eye & Contact Lens
Jianjun Gu, Jiajie Zhai, Guiqing Liao, Jiaqi Chen
PURPOSE: To describe the results of Boston keratoprosthesis implantation in a patient with Stevens-Johnson syndrome following autologous submandibular gland transplantation. DESIGN: Observational case report. METHODS: We report the case of a man diagnosed with Stevens-Johnson syndrome. Autologous submandibular gland transplantation was performed in the right eye in 2008 to ameliorate tear film deficiency. Due to the improvement in the microenvironment of the ocular surface, Boston keratoprosthesis implantation was performed in the right eye in 2011...
October 11, 2016: Ocular Immunology and Inflammation
Tamara L Lenis, Stephan Y Chiu, Simon K Law, Fei Yu, Anthony J Aldave
PURPOSE: To evaluate the safety of concurrent Boston type I keratoprosthesis (KPro) and glaucoma drainage device (GDD) implantation. DESIGN: Retrospective comparative study of a consecutive cohort of patients. SUBJECTS: Patients who underwent KPro implantation by a single surgeon (A.J.A.) with or without 1 concurrent Ahmed GDD (New World Medical, Inc., Rancho Cucamonga, CA) implantation between January 1, 2005, and January 31, 2015, were included...
September 7, 2016: Ophthalmology
Sushmita G Shah, Vatsal S Parikh, Roberto Pineda
No abstract text is available yet for this article.
September 6, 2016: Ocular Immunology and Inflammation
Adam K Muzychuk, Marie-Claude Robert, Stanley Dao, Mona Harissi-Dagher
PURPOSE: To compare the long-term clinical outcomes of fresh versus frozen corneal graft carriers for the Boston Keratoprosthesis type 1 (B-KPro). DESIGN: Prospective, single-center, nonblinded, randomized controlled trial. All participants were followed through the initial study protocol of 24 months and were approached to enter an extension phase, with continuing follow-up visits to 60 months. PARTICIPANTS: All patients undergoing B-KPro surgery between October 2008 and December 2009 by a single experienced surgeon at the Centre Hospitalier de l'Université de Montréal using an allograft carrier were considered...
August 24, 2016: Ophthalmology
Petros Petrou, Philip J Banerjee, Mark Wilkins, Mandeep Singh, Karen Eastlake, G Astrid Limb, David G Charteris
PURPOSE: To review the incidence and features of vitreoretinal complications of a permanent Boston keratoprosthesis and to report the use and outcomes of 23-gauge vitrectomy to manage vitreoretinal pathology. DESIGN: Retrospective non-comparative, interventional case series. SUBJECT, PARTICIPANTS: 27 eyes of 27 patients managed with a Boston keratoprosthesis at Moorfields Eye Hospital over a 3-year period. METHODS: All eyes that underwent pars plana vitrectomy (PPV) and had at least 6 months follow-up were analysed with a specific focus on the anatomical and histological characteristics of retinal detachment and outcomes of surgery...
August 26, 2016: British Journal of Ophthalmology
Ramon Lee, Ziad Khoueir, Edem Tsikata, James Chodosh, Claes H Dohlman, Teresa C Chen
PURPOSE: To report the long-term visual outcomes and complications after Boston keratoprosthesis type II implantation in the largest single-center case series with the longest average follow-up. DESIGN: Retrospective review of consecutive clinical case series. PARTICIPANTS: Between January 1992 and April 2015 at the Massachusetts Eye and Ear Infirmary, 48 eyes of 44 patients had keratoprosthesis type II implanted by 2 surgeons (C.H.D. and J...
August 15, 2016: Ophthalmology
Jacqueline Ng, Don Minckler, Thomas J Walsh, Marjan Farid
PURPOSE: To report a case of recalcitrant Prototheca spp. keratitis and endophthalmitis in a patient with Stevens-Johnson syndrome (SJS) and Boston type 1 keratoprosthesis (B1 KPro). METHODS: Case report. RESULTS: A 67-year-old female with a history of SJS with chronic severe ocular surface disease in her monocular left eye underwent placement of a B1 KPro. Her course was subsequently complicated by persistent Prototheca spp. keratitis and endophthalmitis requiring ongoing treatment with triazole and polyene antifungal agents and multiple surgical revisions of her keratoprosthesis...
September 2016: Cornea
S Siebelmann, B Bachmann, A Lappas, T Dietlein, M Hermann, S Roters, C Cursiefen, P Steven
BACKGROUND: Optical coherence tomography (OCT) is the clinical gold standard for anterior and posterior segment imaging. Since OCT devices have been integrated into surgical microscopes, this technique is also available intraoperatively in anterior segment surgery. OCT is well established in imaging very thin or transparent structures as they appear in corneal or glaucoma surgery. Therefore, intraoperative OCT can deliver important information for the surgeon which is superior to the normal surgical microscope...
August 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Anitha Venugopal, Harshal Rathi, Ramakrishnan Rengappa, Meenakshi Ravindran, Ramalakshmy Raman
PURPOSE: To evaluate outcomes after Auro keratoprosthesis (kpro) implantation. METHODS: Retrospective observational case series. The records of all patients who were implanted with Auro kpro from December 2012 to August 2015 at a single institute were retrospectively analyzed to evaluate preoperative characteristics, postoperative outcomes, and complications. RESULTS: Fifteen cases were included in the study. Failed graft was the most common indication for the surgery (n = 14; 93...
October 2016: Cornea
Clara C Chan, Lorena LoVerde, Judy Qiang, Michael L Nordlund, Edward J Holland
PURPOSE: To determine the rate of Boston type 1 keratoprosthesis (Kpro)-related corneal melts, leaks, and extrusions requiring surgical repair and to analyze possible risk factors and visual outcomes. METHODS: Retrospective chart review of 110 patients (128 eyes) who received a Kpro between November 2004 and December 2010 (average follow-up of 29 mo). The rate of corneal complications, risk factors for melts, and postmelt repair visual outcomes were evaluated. RESULTS: Twenty eyes from 18 patients developed Kpro-related melts requiring surgical repair...
August 2016: Cornea
Carolina Aravena, Tahir Kansu Bozkurt, Fei Yu, Anthony J Aldave
PURPOSE: To report the long-term outcomes of the Boston type I keratoprosthesis (KPro) in the management of limbal stem cell deficiency (LSCD). METHODS: Retrospective review of KPro procedures performed by a single surgeon from May 1, 2004, to January 1, 2015. RESULTS: One hundred seventy-three KPro procedures were performed in 149 eyes, including 68 in 54 eyes with LSCD. Glaucoma (48% vs. 82%, P < 0.0001) and a history of ≥2 keratoplasties (39% vs...
September 2016: Cornea
Gelareh Homayounfar, Christina M Grassi, Ahmad Al-Moujahed, Kathryn A Colby, Claes H Dohlman, James Chodosh
BACKGROUND/AIMS: To determine the outcomes of Boston type I keratoprosthesis implanted in elderly patients. METHODS: A retrospective case series was performed on patients at least 75 years old who received the Boston type I keratoprosthesis between 1 January 2007 and 31 December 2012. Preoperative diagnosis, interval visual acuity, keratoprosthesis retention and postoperative complications were recorded for each patient. RESULTS: Forty-four Boston type I keratoprostheses were implanted in 44 eyes of 43 patients...
July 5, 2016: British Journal of Ophthalmology
Kenneth M Goins, Anna S Kitzmann, Mark A Greiner, Young H Kwon, Wallace L M Alward, Johannes Ledolter, Michael D Wagoner
PURPOSE: To determine the visual outcomes, device retention, and complications after Boston type 1 keratoprosthesis (KPro-1) device implantation. METHODS: Comprehensive review of every case of KPro-1 implantation at a tertiary eye care center. RESULTS: The initial KPro-1 procedure, performed in 75 eyes without a previous keratoprosthesis, was included in the analysis. During the first 6 postoperative months, improvement occurred in the mean preoperative best-corrected visual acuity of 20/1265 to a mean best-obtained postoperative visual acuity of 20/97 (P < 0...
September 2016: Cornea
Marie-Claude Robert, Samer N Arafat, Sandra Spurr-Michaud, James Chodosh, Claes H Dohlman, Ilene K Gipson
PURPOSE: To investigate the tear levels of matrix metalloproteinases (MMPs), myeloperoxidase (MPO), and tissue inhibitor of metalloproteinase-1 in eyes after Boston keratoprosthesis type I (B-KPro) implantation and to correlate these markers with the established B-KPro prognostic categories. METHODS: Tear washes were collected from 40 patients (7 with autoimmune disease, 2 with chemical burn, and 31 with other noncicatrizing diagnoses). Tear levels of MMPs, MPO, and tissue inhibitor of metalloproteinase-1 were quantified using multianalyte bead-based enzyme-linked immunosorbent assays...
July 2016: Cornea
Catherine J Choi, Anna M Stagner, Frederick A Jakobiec, James Chodosh, Michael K Yoon
Boston keratoprosthesis type 2 is used to treat severe corneal blindness secondary to cicatricial or autoimmune ocular surface disease. This case report describes an atypical eyelid mass in a 41-year-old woman with Stevens-Johnson syndrome who underwent placement of Boston keratoprosthesis type 2 in the left eye. The postoperative course was complicated by methicillin-sensitive Staphylococcus aureus keratitis and endophthalmitis requiring replacement of the keratoprosthesis. Three months thereafter, the patient presented with a progressively enlarging upper eyelid mass adjacent to the keratoprosthesis optic causing distortion of the eyelid...
May 9, 2016: Ophthalmic Plastic and Reconstructive Surgery
Borja Salvador-Culla, Kyung Jae Jeong, Paraskevi Evi Kolovou, Homer H Chiang, James Chodosh, Claes H Dohlman, Daniel S Kohane
PURPOSE: We tested the feasibility of using titanium to enhance adhesion of the Boston Keratoprosthesis (B-KPro), ultimately to decrease the risk of implant-associated complications. METHODS: Cylindrical rods were made of poly(methyl methacrylate) (PMMA), PMMA coated with titanium dioxide (TiO2) over a layer of polydopamine (PMMATiO2), smooth (Ti) and sandblasted (TiSB) titanium, and titanium treated with oxygen plasma (Tiox and TiSBox). Topography and surface chemistry were analyzed by scanning electron microscopy (SEM), atomic force microscopy (AFM), and X-ray photoelectron spectroscopy (XPS)...
April 2016: Translational Vision Science & Technology
Rachel A F Wozniak, Mithra Gonzalez, James V Aquavella
PURPOSE: To describe the complex surgical management and novel medical approach for a keratoprosthesis (KPro Boston type I) in a monocular, 73-year-old patient with ectodermal dysplasia and chronic, noninfectious corneal necrosis. METHODS: Best-corrected visual acuity (BCVA) was measured with Snellen letters. Surgical intervention included an amniotic membrane graft, complete replacement of the KPro, conjunctival flap graft, corneal donor tissue grafts combined with inferior rectus muscle advancement, periosteal tissue graft, tarso-conjunctival flap construction, and symblepharolysis...
July 2016: Cornea
Emma Davies, James Chodosh
PURPOSE OF REVIEW: The purpose is to provide an overview of the recent advancements in the diagnosis and treatment of microbial keratitis and endophthalmitis after keratoprosthesis implantation. RECENT FINDINGS: The addition of vancomycin daily to a fluoroquinolone in the postoperative management of keratoprosthesis patients successfully reduced the number of cases of bacterial keratitis and endophthalmitis with an increased number of fungal infections now documented both in the United States and abroad...
July 2016: Current Opinion in Ophthalmology
Jianjun Gu, Jiajie Zhai, Sheng Zhou, Jiaqi Chen
INTRODUCTION: The objective of this study was to report clinical outcomes (functional and anatomic) of Boston keratoprosthesis (KPro) after severe chemical burns in Southern China. METHODS: Nineteen patients (19 eyes) that sustained severe chemical injuries in Southern China were enrolled in this retrospective study in our hospital between May 2009 and June 2015. KPro implantation in these patients was performed by a single experienced surgeon (Jiaqi Chen). The parameters evaluated in this study included diagnosis, comorbidity, preoperative and postoperative visual acuity (VA), complications, KPro retention, histological and immunohistochemical results of retroprosthetic membrane (RPM) and mucous membrane over the optic cylinder...
May 2016: Advances in Therapy
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