Glaucoma Management in Patients With Aniridia and Boston Type 1 Keratoprosthesis
| Autor: | Eleftherios I. Paschalis, James Chodosh, Swapna S Shanbhag, Claes H. Dohlman, Rafaella Nascimento e Silva, Carolina A. Chiou, Milton Ruiz Alves, Kathryn Colby, Lucy Q. Shen, Louis R. Pasquale |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Visual acuity genetic structures Keratoprosthesis medicine.medical_treatment Population Visual Acuity Glaucoma Corneal Diseases Cornea Prosthesis Implantation Tonometry Ocular 03 medical and health sciences Postoperative Complications 0302 clinical medicine Ophthalmology Glaucoma surgery Humans Medicine Glaucoma Drainage Implants education Aniridia Intraocular Pressure Aged Retrospective Studies 030304 developmental biology 0303 health sciences education.field_of_study business.industry Retrospective cohort study Prostheses and Implants Middle Aged medicine.disease eye diseases medicine.anatomical_structure 030221 ophthalmology & optometry Female Artificial Organs sense organs medicine.symptom business Follow-Up Studies |
| Zdroj: | American Journal of Ophthalmology. 207:258-267 |
| ISSN: | 0002-9394 |
| Popis: | Purpose To assess outcomes and glaucoma management in eyes with aniridia following Boston type 1 Keratoprosthesis (KPro) implantation. Design Retrospective, interventional comparative case series. Methods The population included patients with aniridia and patients with other preoperative diagnoses (excluding Stevens-Johnson syndrome, mucous membrane pemphigoid, and congenital disorders) who underwent KPro implantation at Massachusetts Eye and Ear with at least 2 years of follow-up. One eye per patient was selected based on the longer follow-up time. The main outcome was intermediate and long-term outcomes related to glaucoma. Results The aniridia (n = 22) and comparison (n = 61) groups had similar preoperative visual acuity (VA, mean ± standard deviation, 1.86 ± 0.52 logMAR, P = .33) and follow-up time (65.6 ± 26.3 months, P = .25). Before KPro implantation, eyes with aniridia had more glaucoma (76.2%) and glaucoma surgery (57.1%) than comparison eyes (51.8%, P = .053; 23.2%, P = .005, respectively). More Ahmed valves were co-implanted with KPro in aniridia (47.6%) vs comparison eyes (17.9%, P = .008). At final follow-up, more aniridia eyes had glaucoma (90.5%) than comparison eyes (64.3%, P = .02), but the 2 groups had similar percentages of eyes with cup-to-disc ratio (CDR) >0.8 (23.8% vs. 30.4%, P = .57) or CDR progression of ≥0.2 (42.9% vs 44.6%, P = .89, respectively). None of the eyes with prophylactic tube implantation developed glaucoma. Eyes with and without aniridia did not differ in post-KPro VA improvement (72.7%, 72.1%, P = .96), and final VA (1.28 ± 0.79 logMAR, 1.23 ± 0.98 logMAR, P = .51). Conclusion Despite a higher glaucoma prevalence, eyes with aniridia achieved similar VA as comparison eyes with more than 5 years of mean follow-up time. Boston KPro offers satisfactory visual rehabilitation in aniridia when glaucoma is managed aggressively. |
| Databáze: | OpenAIRE |
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