Abstract
Purpose: :
The synthetic Keratoprosthesis can restore visual function in patients affected by corneal blindness that are poor candidates for keratoplasty. Despite great improvements in the prosthesis retention rate, long-term visual prognosis is still uncertain, mainly due to the high rate of glaucoma that may develop with the assessment of IOP possible only by palpation. Ways of evaluating stage and progression on these patients is currently uncertain.
Methods: :
Computerized visual fields, optic nerve analysis with HRT III and retinal nerve fiber layer (RNFL) analysis with OCT were performed to verify feasibility and reliability on 3 eyes of 3 patients that were implanted with a Boston KPro at our institution.
Results: :
All techniques were feasible in the evaluation of the glaucomatous damage in patients implanted with Boston KPro type I. Reliability indexes of HRT, OCT and VF fixation losses were 28,5 μm (±7,8), 38,4 (±7,9), 1,4/17.
Conclusions: :
Patients implanted with a KPro can be monitored for glaucoma with visual field assessment, OCT and HRT III imaging of the optic nerve and retinal nerve fiber layer, allowing precise information on the visual function and on the morphological changes. We found OCT as an easily and quickly performed assessment that can be repeated at each follow-up visit. This reduces the possibility of overlooking worsening glaucoma damage in patients where the IOP can only be assessed approximately.
Keywords: keratoprostheses • imaging/image analysis: clinical • visual fields