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Siamak Zarei-Ghanavati, Carolina Betancurt, Alma M. Mas, Jianhua Wang, Victor L. Perez; Ultra High-Resolution Optical Coherence Tomography in Boston Type I Keratoprosthesis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3619.
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Purpose: To evaluate the anterior keratoprosthesis-cornea interface of the eyes with Boston type 1 keratoprosthesis (Kpro).
Methods: In a prospective non-interventional study, at Bascom Palmer Eye Institute, University of Miami, USA, ten patients with Boston Type I Keratoprosthesis underwent a custom-built ultra high-resolution Optical Coherence Tomography (UHR-OCT) evaluation. The images were used to measure and describe the characteristics of anterior keratoprosthesis-cornea interface, epithelial interaction at keratoprosthesis edge and keratoprosthesis-cornea interface gap.
Results: Ten patients (4 males, 6 females) with Boston Type I Keratoprosthesis with different preoperative diagnosis (8 multiple corneal graft failures and 2 immunological ocular surface diseases) were included in the study. The mean age was 62.1±20.0 years (range: 33.0 - 83.0 years). The mean time between surgery and HR-OCT evaluation was 15.2 months. In eight patients, epithelial growth over the periphery of Kpro was documented. We also detected keratoprosthesis-cornea interface gap in three patients. Two of the patients with the interface gap were among the high risk group. In one patient with severe ocular hypotony, Kpro edge was inserted into the anterior stroma and covers with the epithelium.
Conclusions: UHR-OCT showed that corneal epithelium covers the Kpro edge and seals the opening of potential space between the Kpro and the corneal in 90% of cases. Presence of the gap in the interface was associated to the preoperative high-risk profile for the Kpro implantation. Further studies will be needed to determine the role gap in development of post operative complications.
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