Purpose
Report the utility of ultra-wide field scanning laser ophthalmoscopy imaging in patients with type 1 Boston keratoprosthesis.
Methods
After institutional IRB approval, a retrospective case series was performed on patients who underwent type I Boston Keratoprosthesis from 2009 to present and met the following inclusion criteria: any patient who received keratoprosthesis surgery for any indication and later underwent fundus imaging using the Optos fundus imaging system at the Havener Eye Institute. The charts of 5 patients who met the inclusion criteria were reviewed. Diagnoses, treatments, surgeries, examination findings, and clinical course were recorded. Both standard fundus imaging and Optos imaging were reviewed and compared. Imaging had been obtained in all patients without removal of bandage contact lenses.
Results
The charts of 5 patients who met criteria were reviewed. All patients were female with ages from 30 to 87. Patient characteristics can be found in Table 1. Indications for keratoprosthesis varied with 3 of the patients requiring keratoprosthesis due to bullous keratopathy with a history of failed penetrating keratoplasties, 1 due to aniridia, and 1 due to ocular cicatricial pemphigoid. 4 out of 5 patients had a diagnosis of glaucoma. The optic nerve, macula, and retinal vascular arcades were visible in all photos. The peripheral retina was visible in varying degrees depending on the photo quality. Peripheral retinal pathology can be seen clearly in 1 patient (Figure A). Standard fundus photography obtained on the same eyes resulted in images that were not clinically useful.
Conclusions
UWFSLO (Optos) fundus imaging provides a method of documenting and monitoring fundus pathology in eyes with keratoprosthesis. The use of keratoprosthesis continues to evolve as a treatment modality for patients with severely injured or diseased eyes. Monitoring of glaucoma and retinal pathology in this patient population is facilitated using UWFSLO imaging.
Keywords: 550 imaging/image analysis: clinical