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Borja Salvador Culla, Linette Arzeno, Paraskevi Evi Kolovou, Santiago Martínez, Claes H Dohlman, Miguel Ángel López; Anatomical and visual outcomes after Boston Keratoprosthesis type 1 in chemical burns: the Santo Domingo experience.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1116.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the visual outcomes, anatomical retention and postoperative complications of patients who underwent type 1 Boston Keratoprosthesis (B-Kpro) after ocular chemical burns in the Dominican Republic.
A retrospective review of case series including 42 eyes of 36 patients with ocular chemical burn who underwent B-Kpro type 1 implantation at Hospital Elías Santana in Santo Domingo between September 2006 and October 2014 was conducted. Visual acuity, anatomical retention and the rate of postoperative complications were evaluated.
The mean age of patients was 40.86 years (25-62); 34 were male while 2 were female. The causative agent was ammonia in 21 cases, hydrochloric acid in 6 cases, hydraulic fluid in 1 case, and the agent was unknown in 14 cases. The mean follow-up time was 38.45 months (median 30; range 2-98). Best corrected mean visual acuity (LogMAR) was 2.12 (+/-0.9) at first visit, 2.44 (+/-0.64) immediately prior to B-Kpro implantation, 0.71 (+/-0.61) at 1 month, 0.69 (+/-0.75) at 6 months, 0.95 (+/-0.98) at 1 year, 1.27 (+/-1.30) at 2 years, 1.53 (+/-1.43) at 3 years, 1.25 (+/-1.41) at 4 years, and 1.32 (+/-1.44) at 5 years. Anatomical retention of the first implanted B-Kpro was achieved in 90.5% of the eyes after 1 year and 78.6.3% at 2 years. The most frequent postoperative complication was the development of a posterior capsule opacification (26%), followed by glaucoma (19%) and corneal melting (17%). Other complications included hypotony (5%), extrusion (5%), retroprosthetic membrane (5%), epiretinal membrane (3%), retinal detachment (3%), hemovitreous (3%), endophthalmitis (1%), and Ahmed valve abscess (1%).
Our study demonstrates an excellent retention rate of the B-Kpro type 1 in chemical burns after 2 years, with a maintained improvement of the best corrected visual acuity in the majority of patients. Because these eyes are severely damaged, it is important to follow up closely these patients after B-Kpro implantation to prevent and address promptly any vision-threatening complication.
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