Boston type 1 keratoprosthesis for chemical and thermal injury

David L Phillips; Jonathan L Hager; Kenneth M Goins; Anna S Kitzmann; Mark A Greiner; Alex W Cohen; Jeffrey D Welder; Michael D Wagoner

doi:10.1097/ICO.0000000000000204

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Boston type 1 keratoprosthesis for chemical and thermal injury

Journal article

Peer reviewed

Boston type 1 keratoprosthesis for chemical and thermal injury

David L Phillips, Jonathan L Hager, Kenneth M Goins, Anna S Kitzmann, Mark A Greiner, Alex W Cohen, Jeffrey D Welder and Michael D Wagoner

Cornea, Vol.33(9), pp.905-909

09/2014

DOI: 10.1097/ICO.0000000000000204

PMID: 25055151

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Abstract

To evaluate the outcome of the Boston type 1 keratoprosthesis (Kpro-1) in eyes with failed interventions for chemical and thermal injury. A retrospective review was performed of every eye with chemical or thermal injury that was treated with a Kpro-1 at a tertiary eye care center between January 1, 2008 and July 1, 2013. The main outcome measures were visual outcome, prosthesis retention, and postoperative complications. Nine eyes met the inclusion criteria, including 7 eyes with alkali burns, 1 eye with an acid burn, and 1 eye with a thermal burn. After a mean follow-up of 40.7 months (range, 29-60 months), the median best-corrected visual acuity was 20/60 (range, 20/15 to no light perception). One eye was ≥20/20, 3 eyes were ≥20/40, and 6 eyes were ≥20/70. The initial Kpro-1 prosthesis was retained in 7 (77.7%) eyes and successfully replaced in the other 2 eyes. One or more serious complications occurred in 6 (66.7%) eyes. These included 2 cases of sterile corneal ulceration with prosthesis extrusion, 2 cases of microbial keratitis (1 bacterial and 1 fungal), 2 cases of bacterial endophthalmitis, and 2 cases of retinal detachments. These complications contributed to visual outcomes of hand motions in 2 eyes and no light perception in 1 eye. The Boston Kpro-1 is associated with highly satisfactory visual outcomes and prosthesis retention in most cases of severe chemical or thermal injury. Serious complications are common and may compromise the final outcome.

Artificial Organs

Prosthesis Implantation

Alkalies - adverse effects

Humans

Middle Aged

Eye Burns - surgery

Graft Survival

Male

Burns, Chemical - surgery

Burns, Chemical - physiopathology

Visual Acuity

Corneal Injuries - surgery

Corneal Injuries - physiopathology

Eye Burns - chemically induced

Acids - adverse effects

Adult

Female

Aged

Retrospective Studies

Postoperative Complications

Details

Title: Subtitle: Boston type 1 keratoprosthesis for chemical and thermal injury
Creators: David L Phillips - University of Iowa
Jonathan L Hager
Kenneth M Goins
Anna S Kitzmann
Mark A Greiner
Alex W Cohen - Dean McGee Eye Institute
Jeffrey D Welder
Michael D Wagoner
Resource Type: Journal article
Publication Details: Cornea, Vol.33(9), pp.905-909
DOI: 10.1097/ICO.0000000000000204
PMID: 25055151
NLM abbreviation: Cornea
ISSN: 0277-3740
eISSN: 1536-4798
Publisher: United States
Language: English
Date published: 09/2014
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9983979959502771

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20 Times Cited - Web of Science