Purchase this article with an account.
Brett W. Davies, Kevin Kalwerisky, Sheri L. DeMartelaere; Use of the Boston Ocular Prosthetic Device in the Management of Severe Periorbital Thermal Injuries: A Case Series of Ten Patients. Invest. Ophthalmol. Vis. Sci. 2011;52(14):333.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The battlefield environment of Operations Iraqi Freedom and Enduring Freedom have produced an increased number of casualties with thermal injuries to the face and periorbital region. These injuries often lead to cicatricial lagophthalmos, which in turn results in exposure keratopathy. We present our experience treating these burn patients with refractory exposure keratopathy using the Boston Ocular Prosthetic Device (BOPD).
We present here a case series of 16 eyes from 10 patients treated with the BOPD for exposure keratopathy in the Burn Center at the US Army Institute of Surgical Research from 2008 to 2010. All patients had partial or full thickness burns to face. The length of use ranged from 6 days to 5 months. Treatment criteria included exposure keratopathy refractory to treatment with aggressive lubrication, moisture chamber goggles, and/or tarsorrhaphy. The BOPD were used as a temporary protective measure until scar release and skin grafting could be performed.
Only 1 of 16 eyes required a penetrating keratoplasty, and that was due to thermal injury directly to the corneal surface. While 6 eyes developed corneal ulcers, all healed with the use of fortified antibiotics combined with the BOPD or a ProKera ring. Three of our patients passed away, and two were left with permanent cognitive impairment. Of the 5 patients capable of completing visual acuity testing, all eyes were 20/70 or better, and 5 of the 10 eyes were 20/20. One patient continued to wear his BOPD as an outpatient for improved ocular surface comfort.
The BOPD is an effective treatment for exposure keratopathy resulting from thermal cicatricial changes to the face and eyelids. While not without risks, the BOPD can protect the ocular surface until more definitive surgical treatment can be instituted.
This PDF is available to Subscribers Only