Visual Outcome and Complications of Boston Keratoprosthesis: An Experience from North West Pakistan.
Pak J Ophthalmol Jan ;33(3):142-8.
Purpose: The Purpose of this study is to document the visual outcome and complications of Boston Keratoprosthesis implant in corneal blindness. Study Design: Descriptive case series. Place & Duration of Study: This study was performed at Khyber Teaching Hospital Peshawar from April 2009 to April 2016. Material & Method: Nine eyes of 8 patients were included in the study. In all eyes preoperative visual acuity recorded and slit lamp examination performed. In each case status of anterior segment and diagnosis documented, B-scan performed and Boston keratoprosthesis implanted under general anesthesia. Postoperative visual acuity and complications documented during the course of follow up and data analyzed. Results: Preoperative diagnoses of these patients include Steven Johnson Syndrome in 3 (33.3%) eyes, bomb blast injury in 3 (33.3%) eyes, healed corneal ulcers with failed corneal graft in 2 (22.2%) eyes and Peter anomaly in 1 (11.1%) eye. All the corneas were opaque and vascularized and preoperative visual acuity was perception of light only. In final fallow up visual acuity was 20/200 in 2 (22.2%), 10/200 in 2 (22.2%), 3/200 in 1 (11.1%), perception of light in 3 (33.3%) and no perception of light in 1 (11.1%). Postoperative complications were retro-prosthetic membrane in 6(66.6%) eyes, glaucoma in 1 (11.1%) eye, device extrusion in 3 (33.3%), sterile keratolysis in 3 (33.3%), phthisis bulbi in 3 (33.3%), retinal detachment in 1 (11.1%) and endophthalmitis in 1 (11.1%) eye. Conclusion: Type 1 Boston Keratoprosthesis implant still has poor prognosis in patients with SJS and severely traumatized eye e.g., bomb blast injuries and this is related mainly to preexisting bad eye condition.
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