1 / 8

Experience with Dohlman-Doane keratoprosthesis : case reports

Experience with Dohlman-Doane keratoprosthesis : case reports. Sergio Kwitko, Andressa P. Stolz, Melissa Dal Pizzol, Diane Marinho, Samuel Rymer Ophthalmology Department - Hospital de Clínicas de Porto Alegre Federal University of Rio Grande do Sul - Porto Alegre - Brazil

nolcha
Download Presentation

Experience with Dohlman-Doane keratoprosthesis : case reports

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. ExperiencewithDohlman-Doanekeratoprosthesis: case reports Sergio Kwitko, Andressa P. Stolz, Melissa Dal Pizzol, Diane Marinho, Samuel Rymer Ophthalmology Department - Hospital de Clínicas de Porto AlegreFederal University of Rio Grande do Sul - Porto Alegre - Brazil The authors have no financial interest in the subject matter of this poster

  2. Purpose • To describe 14 eyes of 13 patients who had received Dohlman-Doane type 1 Keratoprostesis (Kpro) with a mean follow-up of 25.5 months (range, 1 to 49 months).

  3. Methods • A retrospective, noncomparative interventional case series. • Previous corneal disease was: • bilateral alkaline burn (5 eyes) • multiple graft failure (6 eyes) • Stevens-Johnson Syndrome (2 eyes) • thermal injury (1 eye) • Best corrected spectacle visual acuity (BSCVA) was hand motions or worse in all eyes. • Glaucoma was present in 3 eyes preoperatively and received Ahmed valve implantation. • Post operative care is the same of conventional penetrating keratoplasty, added with continuous therapeutic contact lens, medroxiprogesterone and antibiotic drops.

  4. Results • 64% of eyes achieved BSCVA of ≥ 20/100 and 42.8% ≥ 20/40 (see table 1). In these eyes, post operative visual field was stable, in 30-50º. • Complications: • 6 eyes: posterior capsule opacification treated with YAG laser capsulotomy; • 5 eyes: corneal necrosis (4 treated with donor cornea bottom exchange); • 3 eyes: retroprosthetic membrane treated with tPA injection; • 2 eyes: vitreitis treated with posterior vitrectomy; • 1 eye: fungal keratitis (ended with post traumatic inoperable retinal detachment); • 1 eye: fusarium endophthalmitis, treated with corneal transplant, anterior vitrectomy, Kpro and intraocular lens explantation, as well as specific intravitreal and endovenous treatment. • 1 eye: eviscerated after irreversible phthisis bulbi occurrence.

  5. Figure 1. Patient 2: Pre(A) and 15 months post K-Pro(B) A B

  6. Table 1: Cases that received Keratoprosthesis implantation

  7. Conclusion • Dohlman Kpro seems to be a good option for cases in witch penetrating keratoplasty contraindications. • Advantages: • does not need systemic immunossupression • good visual outcome. • Best results were achieved in non-immune diseases.

  8. References • Ma JJ, Graney JM, Dohlman CH. Repeat penetrating keratoplasty versus the Boston keratoprosthesis in graft failure. Int Ophthalmol Clin 2005;45:49. • Aquavella JV, Qian Y, McCormick GJ, Palakuru JR. Keratoprosthesis: the Dohlman-Doane device. Am J Ophthalmol 2005;140:1032. • Doane MG, Dohlman CH, Bearse G. Fabrication of a keratoprosthesis. Cornea 1996;15:179. • Zerbe BL, Belin MW, Ciolino JB. Results from the multicenter Boston Type 1 Keratoprosthesis Study. Ophthalmology 2006;113:1779. • Bradley JC, Hernandez EG, Schwab IR, Mannis MJ. Boston type 1 keratoprosthesis: the university of california davis experience. Cornea 2009;28:321. • Sayegh RR, Ang LP, Foster CS, Dohlman CH. The Boston keratoprosthesis in Stevens-Johnson syndrome. Am J Ophthalmol 2008; 145:438. • Barnes SD, Dohlman CH, Durand ML. Fungal colonization and infection in Boston keratoprosthesis. Cornea 2007;26:9. • Aldave AJ, Kamal KM, Vo RC, Yu F. The Boston type I keratoprosthesis: improving outcomes and expanding indications. Ophthalmology 2009; 116:640.

More Related