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Boston type 1 keratoprosthesis: the university of california davis experience.
Cornea 2009; 28(3):321-7C

Abstract

PURPOSE

To compare the University of California Davis experience using the Boston keratoprosthesis with the Boston Keratoprosthesis Study Group's initial report.

DESIGN

Retrospective chart review.

PARTICIPANTS

We analyzed 30 eyes of 28 patients who previously underwent Boston type 1 keratoprosthesis surgery at our institution between 2004 and 2008.

METHODS

Preoperative, intraoperative, and postoperative parameters were collected and analyzed.

MAIN OUTCOME MEASURES

Visual acuity and keratoprosthesis stability.

RESULTS

Preoperative diagnoses were failed graft (26 eyes, 87%), chemical injury (3 eyes, 10%), and Stevens-Johnson syndrome (1 eye, 3%). Twenty eyes (66%) had preoperative glaucoma. Preoperative best-corrected visual acuity ranged from 20/150 to light perception and was <20/200 in 83% of eyes. At an average follow-up of 19 months (range, 1-48; SD, 13.8; and median, 13), postoperative vision improved to >or=20/200 in 77% of eyes. Among eyes at least 1 year after the operation (16 eyes), vision was >or=20/200 in 75% of eyes and >or=20/40 in 25% of eyes. At an average follow-up of 19 months, retention of the initial keratoprosthesis was 83.3%.

CONCLUSIONS

The Boston type 1 keratoprosthesis is a viable option after multiple keratoplasty failures or in conditions with a poor prognosis for primary keratoplasty. Patients with autoimmune disease are at higher risk for complications. The University of California Davis experience seems equivalent to the initial report of the Boston Keratoprosthesis Study Group. With longer follow-up, additional surgical procedures may be required but good anatomic and functional outcomes can be maintained.

Authors+Show Affiliations

Department of Ophthalmology & Vision Science, University of California Davis, Sacramento, CA 95817, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19387235

Citation

Bradley, Jay C., et al. "Boston Type 1 Keratoprosthesis: the University of California Davis Experience." Cornea, vol. 28, no. 3, 2009, pp. 321-7.
Bradley JC, Hernandez EG, Schwab IR, et al. Boston type 1 keratoprosthesis: the university of california davis experience. Cornea. 2009;28(3):321-7.
Bradley, J. C., Hernandez, E. G., Schwab, I. R., & Mannis, M. J. (2009). Boston type 1 keratoprosthesis: the university of california davis experience. Cornea, 28(3), pp. 321-7. doi:10.1097/ICO.0b013e31818b8bfa.
Bradley JC, et al. Boston Type 1 Keratoprosthesis: the University of California Davis Experience. Cornea. 2009;28(3):321-7. PubMed PMID: 19387235.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Boston type 1 keratoprosthesis: the university of california davis experience. AU - Bradley,Jay C, AU - Hernandez,Enrique Graue, AU - Schwab,Ivan R, AU - Mannis,Mark J, PY - 2009/4/24/entrez PY - 2009/4/24/pubmed PY - 2009/6/18/medline SP - 321 EP - 7 JF - Cornea JO - Cornea VL - 28 IS - 3 N2 - PURPOSE: To compare the University of California Davis experience using the Boston keratoprosthesis with the Boston Keratoprosthesis Study Group's initial report. DESIGN: Retrospective chart review. PARTICIPANTS: We analyzed 30 eyes of 28 patients who previously underwent Boston type 1 keratoprosthesis surgery at our institution between 2004 and 2008. METHODS: Preoperative, intraoperative, and postoperative parameters were collected and analyzed. MAIN OUTCOME MEASURES: Visual acuity and keratoprosthesis stability. RESULTS: Preoperative diagnoses were failed graft (26 eyes, 87%), chemical injury (3 eyes, 10%), and Stevens-Johnson syndrome (1 eye, 3%). Twenty eyes (66%) had preoperative glaucoma. Preoperative best-corrected visual acuity ranged from 20/150 to light perception and was <20/200 in 83% of eyes. At an average follow-up of 19 months (range, 1-48; SD, 13.8; and median, 13), postoperative vision improved to >or=20/200 in 77% of eyes. Among eyes at least 1 year after the operation (16 eyes), vision was >or=20/200 in 75% of eyes and >or=20/40 in 25% of eyes. At an average follow-up of 19 months, retention of the initial keratoprosthesis was 83.3%. CONCLUSIONS: The Boston type 1 keratoprosthesis is a viable option after multiple keratoplasty failures or in conditions with a poor prognosis for primary keratoplasty. Patients with autoimmune disease are at higher risk for complications. The University of California Davis experience seems equivalent to the initial report of the Boston Keratoprosthesis Study Group. With longer follow-up, additional surgical procedures may be required but good anatomic and functional outcomes can be maintained. SN - 1536-4798 UR - https://www.unboundmedicine.com/medline/citation/19387235/Boston_type_1_keratoprosthesis:_the_university_of_california_davis_experience_ L2 - http://dx.doi.org/10.1097/ICO.0b013e31818b8bfa DB - PRIME DP - Unbound Medicine ER -