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Kareem Moussa, John Petrowski, Natalie Afshari; The effect of the presence of preoperative silicone oil, absence of prior corneal surgery, and postoperative scleral contact lens use on Boston keratoprosthesis outcomes. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3475.
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© ARVO (1962-2015); The Authors (2016-present)
To report outcomes of the Boston keratoprosthesis in eyes with a preoperative history of silicone oil, eyes with no prior corneal surgery, as well as eyes that received a scleral contact lens postoperatively.
Retrospective chart review. Preoperative, intraoperative, and postoperative data were collected from a total of 17 eyes from 16 patients who received a Boston keratoprosthesis and had previous silicone oil, absence of prior corneal surgery, or postoperative scleral lens use.
17 eyes from 16 patients were included in the study. Four eyes (24%) had silicone oil prior to keratoprosthesis placement, ten eyes (59%) had no prior history of corneal surgery, and four eyes (24%) received a Jupiter scleral contact lens following the operation. In the four eyes that had silicone oil prior to keratoprosthesis placement, preoperative visual acuity ranged from light perception to hand motion. All four eyes (100%) developed retroprosthesis membranes postoperatively, three of which (75%) required surgical excision. Only one eye (25%) attained visual acuity ≥20/200 at a follow-up of 29 months. In the ten eyes with no prior history of corneal surgery, preoperative visual acuity ranged from light perception to 20/400. Postoperatively, eight eyes (80%) attained visual acuity ≥20/200 at an average follow-up of 22.8 months. In the four eyes that received a scleral contact lens (SCL) following the operation, preoperative visual acuity ranged from hand motion to 20/400. Postoperatively, all four eyes (100%) attained visual acuity ≥20/200 at an average follow-up of 11.7 months.
Implantation of a Boston keratoprosthesis in eyes that previously had silicone oil should be considered with caution as these eyes may have poor postoperative visual acuity and may develop dense retroprosthesis membranes. The Boston keratoprosthesis has favorable visual acuity outcomes in eyes without a prior history of corneal surgery. Postoperative use of scleral contact lenses in patients with keratoprosthesis is well-tolerated.
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