Long-term outcomes of the aphakic snap-on Boston type I keratoprosthesis at the Bascom Palmer Eye Institute

Allister Gibbons,1 Ella H Leung,1 Luis J Haddock,1 Carlos A Medina,1 Viviana Fernandez,2 Jean-Marie A Parel,1,2 Heather A Durkee,2 Guillermo Amescua,1 Eduardo C Alfonso,1 Victor L Perez1,3 1Bascom Palmer Eye Institute/University of Miami Miller School of Medicine, Miami, FL, 2Ophthalmic Biophysics...

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Autores principales:	Gibbons A, Leung EH, Haddock LJ, Medina CA, Fernandez V, Parel JMA, Durkee HA, Amescua G, Alfonso EC, Perez VL
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Keratoprosthesis Corneal blindness Aphakia Penetrating Keratoplasty Snap-On Type I Keratoprosthesis Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/7e1abcb863fc4870a8e7b91545b597c6
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spelling	oai:doaj.org-article:7e1abcb863fc4870a8e7b91545b597c62021-12-02T07:43:19ZLong-term outcomes of the aphakic snap-on Boston type I keratoprosthesis at the Bascom Palmer Eye Institute1177-5483https://doaj.org/article/7e1abcb863fc4870a8e7b91545b597c62018-02-01T00:00:00Zhttps://www.dovepress.com/long-term-outcomes-of-the-aphakic-snap-on-boston-type-i-keratoprosthes-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Allister Gibbons,1 Ella H Leung,1 Luis J Haddock,1 Carlos A Medina,1 Viviana Fernandez,2 Jean-Marie A Parel,1,2 Heather A Durkee,2 Guillermo Amescua,1 Eduardo C Alfonso,1 Victor L Perez1,3 1Bascom Palmer Eye Institute/University of Miami Miller School of Medicine, Miami, FL, 2Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, 3Ocular Surface Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA Purpose: To determine the indications, long-term clinical and visual outcomes, and complications of the aphakic snap-on type I Boston keratoprosthesis (KPro). Design: Retrospective, non-comparative case series. Methods: Forty-five eyes of 43 patients with type I aphakic snap-on KPros with at least 1 year of follow-up were included. The past medical histories, preoperative indications, best-corrected visual acuities (BCVAs), postoperative complications, and retention rates were analyzed. Results: The most common indication for KPro implantation was a failed corneal graft (89%). The mean preoperative BCVA was count fingers–hand motion (2.14±0.45 logarithm of minimum angle of resolution [logMAR]), which initially improved to 20/200 (1.04±0.85 logMAR; P<0.0001). At the last examination, 24 eyes (53%) maintained some visual gain, 22% retained their preoperative visual acuity, and 24% lost vision due to postoperative events and underlying ocular comorbidities. Postoperative complications included retroprosthetic membranes (8/45, 18%), corneal melts (5/45, 11%), glaucoma progression (6/45, 13%), and endophthalmitis or sterile vitritis (6/45, 13%). The KPro retention rate was 89%, with a mean follow-up of 51 months. The mean BCVA at the last visit was 20/1,400 (1.82±0.92 logMAR). Conclusion: Most patients experienced improved visual acuity after the implantation of the aphakic, snap-on type I KPro; however, the visual gains were not sustained over time, correlating with the onset of postoperative complications. Keywords: keratoprosthesis, corneal blindness, aphakia, penetrating keratoplasty, snap-on type I keratoprosthesisGibbons ALeung EHHaddock LJMedina CAFernandez VParel JMADurkee HAAmescua GAlfonso ECPerez VLDove Medical PressarticleKeratoprosthesisCorneal blindnessAphakiaPenetrating KeratoplastySnap-On Type I KeratoprosthesisOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 331-337 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Keratoprosthesis Corneal blindness Aphakia Penetrating Keratoplasty Snap-On Type I Keratoprosthesis Ophthalmology RE1-994
spellingShingle	Keratoprosthesis Corneal blindness Aphakia Penetrating Keratoplasty Snap-On Type I Keratoprosthesis Ophthalmology RE1-994 Gibbons A Leung EH Haddock LJ Medina CA Fernandez V Parel JMA Durkee HA Amescua G Alfonso EC Perez VL Long-term outcomes of the aphakic snap-on Boston type I keratoprosthesis at the Bascom Palmer Eye Institute
description	Allister Gibbons,1 Ella H Leung,1 Luis J Haddock,1 Carlos A Medina,1 Viviana Fernandez,2 Jean-Marie A Parel,1,2 Heather A Durkee,2 Guillermo Amescua,1 Eduardo C Alfonso,1 Victor L Perez1,3 1Bascom Palmer Eye Institute/University of Miami Miller School of Medicine, Miami, FL, 2Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, 3Ocular Surface Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA Purpose: To determine the indications, long-term clinical and visual outcomes, and complications of the aphakic snap-on type I Boston keratoprosthesis (KPro). Design: Retrospective, non-comparative case series. Methods: Forty-five eyes of 43 patients with type I aphakic snap-on KPros with at least 1 year of follow-up were included. The past medical histories, preoperative indications, best-corrected visual acuities (BCVAs), postoperative complications, and retention rates were analyzed. Results: The most common indication for KPro implantation was a failed corneal graft (89%). The mean preoperative BCVA was count fingers–hand motion (2.14±0.45 logarithm of minimum angle of resolution [logMAR]), which initially improved to 20/200 (1.04±0.85 logMAR; P<0.0001). At the last examination, 24 eyes (53%) maintained some visual gain, 22% retained their preoperative visual acuity, and 24% lost vision due to postoperative events and underlying ocular comorbidities. Postoperative complications included retroprosthetic membranes (8/45, 18%), corneal melts (5/45, 11%), glaucoma progression (6/45, 13%), and endophthalmitis or sterile vitritis (6/45, 13%). The KPro retention rate was 89%, with a mean follow-up of 51 months. The mean BCVA at the last visit was 20/1,400 (1.82±0.92 logMAR). Conclusion: Most patients experienced improved visual acuity after the implantation of the aphakic, snap-on type I KPro; however, the visual gains were not sustained over time, correlating with the onset of postoperative complications. Keywords: keratoprosthesis, corneal blindness, aphakia, penetrating keratoplasty, snap-on type I keratoprosthesis
format	article
author	Gibbons A Leung EH Haddock LJ Medina CA Fernandez V Parel JMA Durkee HA Amescua G Alfonso EC Perez VL
author_facet	Gibbons A Leung EH Haddock LJ Medina CA Fernandez V Parel JMA Durkee HA Amescua G Alfonso EC Perez VL
author_sort	Gibbons A
title	Long-term outcomes of the aphakic snap-on Boston type I keratoprosthesis at the Bascom Palmer Eye Institute
title_short	Long-term outcomes of the aphakic snap-on Boston type I keratoprosthesis at the Bascom Palmer Eye Institute
title_full	Long-term outcomes of the aphakic snap-on Boston type I keratoprosthesis at the Bascom Palmer Eye Institute
title_fullStr	Long-term outcomes of the aphakic snap-on Boston type I keratoprosthesis at the Bascom Palmer Eye Institute
title_full_unstemmed	Long-term outcomes of the aphakic snap-on Boston type I keratoprosthesis at the Bascom Palmer Eye Institute
title_sort	long-term outcomes of the aphakic snap-on boston type i keratoprosthesis at the bascom palmer eye institute
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/7e1abcb863fc4870a8e7b91545b597c6
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Long-term outcomes of the aphakic snap-on Boston type I keratoprosthesis at the Bascom Palmer Eye Institute

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