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L. M. Wigington, J. W. Cowden; The Use of Keratoprosthesis Following Epithelial Downgrowth. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2336.
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To report four cases of keratoprostheses following successfully treated epithelial downgrowth.
Retrospective chart review
Epithelial downgrowth occurred in four post-keratoplasty patients. One case related to a glaucoma tube shunt removal, one case related to a suture tract, and two related to persistent wound leak despite repeat suture repair. Standard treatment was a large diameter penetrating keratoplasty with removal of intraocular lens if present and removal of epithelial downgrowth along with portions of involved iris, and cryotherapy. There was graft rejection in all four cases. Keratoprostheses were then placed with three being retained for at least 2 years to date. One keratoprosthesis extruded and required a repeat large diameter graft which remains clear. All patients are monocular with hand motion vision in the involved eye.
A keratoprosthesis is an acceptable approach to salvage vision after successfully treated epithelial downgrowth.
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