Boston Type II Keratoprosthesis, 7 Years of Experience and Outcomes From a Spanish Tertiary Eye Care Hospital.

Autor: Orive Bañuelos A; From the Department of Ophthalmology (A.O.B., C.S.E., A.S.C., R.F.L., N.A.V., J.E.E.), BioCruces Bizkaia Health Research Institute, University Hospital of Cruces, Barakaldo, Spain. Electronic address: orive.a@hotmail.com., Sacristán Egüén C; From the Department of Ophthalmology (A.O.B., C.S.E., A.S.C., R.F.L., N.A.V., J.E.E.), BioCruces Bizkaia Health Research Institute, University Hospital of Cruces, Barakaldo, Spain., Arce Soto A; Department of Ophthalmology (A.A.S.), Hospital of Manacor, Spain., Santamaría Carro A; From the Department of Ophthalmology (A.O.B., C.S.E., A.S.C., R.F.L., N.A.V., J.E.E.), BioCruces Bizkaia Health Research Institute, University Hospital of Cruces, Barakaldo, Spain., Feijóo Lera R; From the Department of Ophthalmology (A.O.B., C.S.E., A.S.C., R.F.L., N.A.V., J.E.E.), BioCruces Bizkaia Health Research Institute, University Hospital of Cruces, Barakaldo, Spain., Andollo Victoriano N; From the Department of Ophthalmology (A.O.B., C.S.E., A.S.C., R.F.L., N.A.V., J.E.E.), BioCruces Bizkaia Health Research Institute, University Hospital of Cruces, Barakaldo, Spain; Department of Cell Biology and Histology (N.A.V., J.E.E.), School of Medicine and Nursing, University of the Basque Country, Leioa, Spain., Etxebarria Ecenarro J; From the Department of Ophthalmology (A.O.B., C.S.E., A.S.C., R.F.L., N.A.V., J.E.E.), BioCruces Bizkaia Health Research Institute, University Hospital of Cruces, Barakaldo, Spain; Department of Cell Biology and Histology (N.A.V., J.E.E.), School of Medicine and Nursing, University of the Basque Country, Leioa, Spain.
Jazyk: angličtina
Zdroj: American journal of ophthalmology [Am J Ophthalmol] 2024 Aug 29; Vol. 269, pp. 327-338. Date of Electronic Publication: 2024 Aug 29.
DOI: 10.1016/j.ajo.2024.08.010
Abstrakt: Purpose: To report midterm outcomes of Boston Keratoprosthesis type II at a reference center in Spain.
Design: Retrospective case series.
Methods: This observational study included medical records of 9 patients who underwent Boston Keratoprosthesis type II surgery at Cruces University Hospital from May 2016 through May 2023. A total of 9 eyes received this device during the study period. One patient who had undergone a modification of the standard procedure was excluded. Preoperative and postoperative parameters were studied. The main outcomes analyzed were visual acuity, device retention, and complications and their management.
Results: The most common indication for implantation was severe Sjögren syndrome (33.3%) followed by graft-versus-host disease (22.2%). The mean follow-up was 3.89 years (±2.08). Visual acuity improved to better than or equal to 20/40 in 8 eyes (88.8%) and 20/25 in 6 eyes (66.6%), while best-corrected visual acuity of 20/20 was achieved in 4 eyes (44.4%). At the last visit, maximum visual acuity was maintained in 4 patients. The most common postoperative complication was retroprosthetic membrane formation (77.7%). New-onset glaucoma was detected in 4 patients (44.4%). Device extrusion occurred in 1 eye and 2 more patients required replacement surgery. All but 1 of the patients are on postoperative treatment with systemic immunosuppressants.
Conclusions: The Boston type II Keratoprosthesis is a useful option for visual rehabilitation in end-stage ocular surface diseases. Multidisciplinary management of complications is of vital importance for the maintenance of vision and the device. Immunosuppressive treatment helps control the inflammation that leads to most associated complications.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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