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R. Michael, M. F. de la Paz, V. Charoenrook, S. Sel, J. Temprano, R. I. Barraquer; Impact of Clinical Factors on the Long-Term Functional and Anatomical Results of Osteo- and Osteoodonto-Keratoprosthesis. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1496.
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To analyze the functional and anatomical results of keratoprosthesis using tooth and tibial autograft.
We reviewed 227 charts of patients that underwent osteo-keratoprosthesis (OKP) (n=82) or osteoodonto-keratoprosthesis (OOKP) (n=145) at the Centro de Oftalmología Barraquer. Mean follow-up time was 8.4 years for OOKP and 3.5 years for OKP. Multivariate analysis (Cox regression model) was applied to test the impact of clinical factors on functional and anatomical survival. Anatomical success was defined as retention of the keratoprosthesis lamina and functional success as BCVA >0.05. We included surgical technique, six primary diagnosis groups (chemical burn; thermal burn; Steven Johnson and Lyell syndrome; ocular cicatricial pemphigoid [OCP]; trachoma; others), age, sex, retinal potential and the five most common post-operative complications (infection; vitreous hemorrhage; retinal detachment; glaucoma; retroprosthetic membrane).
Overall mean 10 year anatomical survival was 62% and functional survival was 59% after 2 years and 32% after 10 years. OOKP tended to give better results than OKP, but multivariate analysis showed that the surgical technique had no significant impact on anatomical (p=0.06) and functional (p=0.15) results. OCP had the worst prognostic for anatomical and functional survival. Age, retinal potential and post-operative complications had no significant impact on anatomical survival, but on functional survival.
Among the clinical factors studies, only primary diagnosis had significant influence on anatomical results. Functional results were significantly influenced by the retinal potential, age, primary diagnosis and post-op complications.
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