June 2013
Volume 54, Issue 15
ARVO Annual Meeting Abstract  |   June 2013
Treatment Outcomes of Cystoid Macular Edema in Patients with Boston Type I Keratoprosthesis
Author Affiliations & Notes
  • Randee Miller
    University of Illinois at Chicago, Chicago, IL
  • Kaitlyn Wallace
    University of Illinois at Chicago, Chicago, IL
  • Joshua Hou
    University of Illinois at Chicago, Chicago, IL
  • Clement Chow
    University of Illinois at Chicago, Chicago, IL
  • Jose De la Cruz
    University of Illinois at Chicago, Chicago, IL
  • Maria Cortina
    University of Illinois at Chicago, Chicago, IL
  • Felix Chau
    University of Illinois at Chicago, Chicago, IL
  • Footnotes
    Commercial Relationships Randee Miller, None; Kaitlyn Wallace, None; Joshua Hou, None; Clement Chow, None; Jose De la Cruz, alcon (C), amo (C); Maria Cortina, None; Felix Chau, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 263. doi:
  • Views
  • Share
  • Tools
    • Alerts
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Randee Miller, Kaitlyn Wallace, Joshua Hou, Clement Chow, Jose De la Cruz, Maria Cortina, Felix Chau; Treatment Outcomes of Cystoid Macular Edema in Patients with Boston Type I Keratoprosthesis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):263.

      Download citation file:

      © ARVO (1962-2015); The Authors (2016-present)

  • Supplements

Purpose: Cystoid macular edema (CME) is a common complication of Boston keratoprosthesis (Kpro) implantation, for which there is no standard treatment protocol. In this study we report our experience with several established therapies for CME.

Methods: Medical records of all patients who underwent implantation of Kpro at Illinois Eye and Ear Infirmary from Feb 2007- Nov 2012 were retrospectively reviewed. Eyes with CME as confirmed on spectral domain optical coherence tomography (SD-OCT) in the postoperative period were included. Outcome measures included visual acuity (VA), intraocular pressure, SD-OCT macular thickness, type, frequency, and duration of treatment including topical steroids and non-steroidals, posterior sub-tenon (PST) and intravitreal triamcinolone (IVT), intravitreal bevacizumab, and dexamethasone implant (Ozurdex). Structural outcomes were categorized into resolution (R), improvement (I), stable (S), or worsened (W).

Results: 105 Kpro were implanted into 91 eyes of 85 patients over a 5 year period. 19 of 91 eyes (21%) were diagnosed with CME postoperatively. The median time from Kpro to diagnosis of CME was 3 months. The median follow up time was 21.9 months. The median VA at time of CME diagnosis was 20/200 and the median initial OCT macular thickness was 519 µm. 10 eyes had topical treatment only (3R, 3I, 2S, 2W). 9 eyes had additional treatments with injections: 1 had intravitreal bevacizumab (S); 1 had PST and IVT (S); 1 had PST, IVT and bevacizumab (W); 3 had at least one Ozurdex (1R, 2I) and 3 had PST, IVT, and Ozurdex (3I). The 8 steroid injected eyes received a median of 3 treatments over a median of 24.7 months. Overall, the median final VA was 20/250 (p= 0.25) and median final OCT macular thickness was 413 µm (p= 0.005). 4 eyes with pre-existing glaucoma had a transient pressure spike >30 mmHg following steroid injection; 3 were treated successfully with topical medication (3/4) and one required a glaucoma shunt procedure (1/4). There were no other ocular complications.

Conclusions: Treatment of CME following Kpro can be challenging. Corticosteroids remain a mainstay of treatment and anatomic improvement may occur in the absence of visual acuity improvement. Twelve of 19 eyes exhibited resolution or improvement of CME, including all 6 eyes treated with Ozurdex; four of these 12 eyes had improved visual acuity. Ozurdex may be beneficial in treating chronic Kpro CME.

Keywords: 575 keratoprostheses • 505 edema  

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.