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B.F. Khan, M. Harissi–Dagher, A.V. Turalba, C.H. Dohlman; Herpetic Keratitis and Aniridia : Boston Keratoprosthesis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3933.
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A small patient series of herpetic keratitis and aniridia were reviewed. These diseases have been suspected of carrying a questionable prognosis for keratoprosthesis.
A retrospective chart review identified 10 patients with herpetic keratitis (9 simplex and 1 zoster) and 3 cases of aniridia who underwent Boston Keratoprosthesis (KPro) surgery. Preoperative, best post operative and last follow up vision was recorded. Both pre operative co–morbid conditions and post operative complications were recorded.
The 10 herpetic patients had a mean of 2.6 keratoplasties before the keratoprosthesis surgery. Vision pre op ranged from light perception (LP) to count fingers(CF), best post op from 20/25 to 20/400, and at last follow up 20/30 to no light perception ( one case secondary to glaucoma). Follow up ranged from 2 mths to 74 mths, average of 44 mths. Pre KPro conditions included glaucoma (7), AMD (3), CME (2), scleral buckle (1). Post KPro complications were retro KPro membrane in three cases and fungal keratitis in one case. Two cases of HSV had active inflammation and ulceration pre operatively which rapidly quieted after surgery. The three aniridia patients all had glaucoma and optic nerve hypoplasia pre operatively. One had two PK’s and two had none. Pre operative vision was CF in two and LP in one. The last vision recorded was 20/60 (74mths), 20/200 (73 mths) and hand motions (17mths). One tissue melt was repaired but without removal.
The KPro maintained long term stability of the eyes in all cases. There were no extrusions. All the implantations resulted in completely quiet eyes. Co–morbid pre operative conditions particularly glaucoma limited vision in both groups and optic nerve hypoplasia in aniridia patients. Hence in herpetic keratitis and in aniridia the Boston KPro seems well tolerated.
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