July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Visual outcomes and complications with Boston Type 1 Keratoprosthesis in an ophthalmology referral center in Mexico City from 2010 to 2018
Author Affiliations & Notes
  • Carlos Adolfo Muller Morales
    Cornea and Refractive Surgery, Instituto de Oftalmolog�a Conde de Valenciana, Mexico City, DF, Mexico
  • Arturo J Ramirez-Miranda
    Cornea and Refractive Surgery, Instituto de Oftalmolog�a Conde de Valenciana, Mexico City, DF, Mexico
  • Alejandro Navas
    Cornea and Refractive Surgery, Instituto de Oftalmolog�a Conde de Valenciana, Mexico City, DF, Mexico
  • Enrique O Graue-Hernandez
    Cornea and Refractive Surgery, Instituto de Oftalmolog�a Conde de Valenciana, Mexico City, DF, Mexico
  • Footnotes
    Commercial Relationships   Carlos Muller Morales, None; Arturo Ramirez-Miranda, None; Alejandro Navas, None; Enrique Graue-Hernandez, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6317. doi:https://doi.org/
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      Carlos Adolfo Muller Morales, Arturo J Ramirez-Miranda, Alejandro Navas, Enrique O Graue-Hernandez; Visual outcomes and complications with Boston Type 1 Keratoprosthesis in an ophthalmology referral center in Mexico City from 2010 to 2018. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6317. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Evaluate visual outcomes, complications and retention rate after Boston type 1 keratoprosthesis (KPro) implantation in an ophthalmology referral center in Mexico City

Methods : Retrospective chart review of patients who underwent a KPro implantation from 2010-2018 at the Instituto de Oftalmologia Conde de Valenciana Mexico City. Information including epidemiological data, visual acuity and complications were collected from records into a database for analysis using SPSS 20

Results : A total of 21 eyes with KPro implantation were included; 13 (62%) were males. Mean age was 52.7. Each eye had undergone an average of 0.80 prior corneal transplants (range 0–3; SD 0.87). Most common preoperative diagnosis was failed graft 38.09%, chemical injury 28.57%, limbal stem cell deficiency 23.8%, Axenfeld Rieger 4.7% and congenital aniridia 4.7%. Preoperative visual acuity ranged from 20/300 to light perception. The number of eyes with BCVA of 20/300 increased from 4.7% before surgery to 52.3% at the last follow-up visit recorded, over an average follow-up period of 41.7 mos (range 12–72 mos; SD 16.4 mos; median 48.0 mos). The percentage of eyes with postoperative BCVA of 20/300 or better was 61% (13/21) at 12 mos, 57% (11/19) at 24 mos, 60% (9/15) at 36 mos, 53.8% (7/13) at 48 mos, 75% (3/4) at 60 mos, and 100% (1/1) at 72 mos. Final postoperative vision was improved over the preoperative vision in 61%, was unchanged in 19% and decreased in 19%. No postoperative complications were achieved in 42.8%. The most common complication was increased IOP in 5 eyes 23.8%; all achieved IOP control after shunt tube procedure (3), diode laser transcleral cyclophotocoagulation (1) or topical antihypertensive medication (1). Second most common complication was retroprosthetic membrane in 3 eyes 14.2%, all of them treated with YAG laser membranectomy. Other complications: corneal melt 17%, endophthalmitis 4.7%, progression of glaucoma 9.5%, and ocular trauma 4.7%. Retention rate of the KPro at an average follow-up of 41.7 mos. (range 12–72 mos; SD 16.4 mos; median 48.0 mos) was 90.4%, with 2 failures. Causes included corneal melting and ocular trauma. Both treated with removal of KPro and tectonic penetrating keratoplasty

Conclusions : Boston type 1 keratoprosthesis is a viable option after multiple KP failures or in conditions with a poor prognosis for primary KP

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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