Incidence, Risk Factors, and Surgical Management of Boston Type 1 Keratoprothesis Corneal Melts, Leaks, and Extrusions
| Autor: | Clara C. Chan, Judy Qiang, Lorena LoVerde, Edward J. Holland, Michael L. Nordlund |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Visual acuity Keratoprosthesis Enucleation Visual Acuity Infectious Keratitis Corneal Diseases Cornea Surgical Wound Dehiscence 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Humans Aged Retrospective Studies Aged 80 and over Bioprosthesis Surgical repair business.industry Incidence Middle Aged eye diseases Prosthesis Failure Surgery Ophthalmology medicine.anatomical_structure 030221 ophthalmology & optometry Female Artificial Organs medicine.symptom business Keratoplasty Penetrating 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Cornea. 35:1049-1056 |
| ISSN: | 0277-3740 |
| Popis: | PURPOSE To determine the rate of Boston type 1 keratoprosthesis (Kpro)-related corneal melts, leaks, and extrusions requiring surgical repair and to analyze possible risk factors and visual outcomes. METHODS Retrospective chart review of 110 patients (128 eyes) who received a Kpro between November 2004 and December 2010 (average follow-up of 29 mo). The rate of corneal complications, risk factors for melts, and postmelt repair visual outcomes were evaluated. RESULTS Twenty eyes from 18 patients developed Kpro-related melts requiring surgical repair. The incidence of melt-related complications was 16%. In total, there were 33 episodes of melt-related complications. Surgical repair included lamellar patch grafts (15), Kpro removal with penetrating keratoplasty (7), reassembly of Kpro onto a new cornea (4), replacement of Kpro (3), suturing of a leak (3), and enucleation (1). The majority of eyes (18/20) did not regain their best post-Kpro vision at final follow-up (average 10 mo and range, 1-36 mo after melt repair). Significant risk factors for melt included previous infectious keratitis [P < 0.0001, odds ratio (OR) = 12.50, 95% confidence interval (CI), 4.02-38.9] and conjunctival deficiency (ie, a diagnosis of Stevens-Johnson syndrome, mucous membrane pemphigoid, or chemical injury, P = 0.043, OR = 2.66, CI, 1.01-7.02). CONCLUSIONS Patients who undergo Kpro with severe ocular surface disease are at greater risk for corneal melts, leaks, and extrusions. Patients with infectious keratitis and conjunctival deficiency are at an increased risk of developing corneal melts. Visual outcomes are poor after surgical repair of these complications. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|