fatai oluyadi n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Fatai OLUYADI PowerPoint Presentation
Download Presentation
Fatai OLUYADI

Loading in 2 Seconds...

play fullscreen
1 / 15

Fatai OLUYADI - PowerPoint PPT Presentation


  • 118 Views
  • Uploaded on

Fatai OLUYADI. KERATOPROSTHESIS in EYE FOUNDATION HOSPITAL. Keratoprosthesis is a surgical procedure where a severely damaged or diseased cornea is replaced with an artificial cornea.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Fatai OLUYADI' - gautam


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.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
fatai oluyadi

Fatai OLUYADI

KERATOPROSTHESIS in EYE FOUNDATION HOSPITAL

keratoprosthesis

Keratoprosthesis is a surgical procedure where a severely damaged or diseased cornea is replaced with an artificial cornea.

  • Keratoprotheses are made of clear plastic with excellent tissue tolerance and optical properties. They vary in design, size and in the implantation techniques.
  • The idea of artificial cornea was first proposed in 1789 by French ophthalmologist Guillaume Pellier de Quengsy.
  • The first reported human KPro surgery with a quartz crystal implant was performed by Nussbaum in 1855
KERATOPROSTHESIS
keratoprosthesis types

SINGH WORST KPro

  • BOSTON Kpro
  • OSTEO-ODONTO Kpro
  • ALPHA-COR KPro
Keratoprosthesis -types
indications contraindications

Multiple graft failure

  • Stevens-Johnson syndrome
  • Ocular cicatricialpemphigoid
  • Ocular burns (acid and alkali, thermal)
  • and other conditions with poor prognosis with traditional PKP
  • Procedure of last resort

- to give at least navigational vision

- not done if BVA both eyes > or= CF

INDICATIONS & CONTRAINDICATIONS
slide5

STEVEN JOHNSONS SYNDROMES

Vascularized cornea

Central KPro in a patient with Acid burns 8yrs post-op VA 6/36

complications

Most common postoperative complications in order of decreasing prevalence include:

  • Retroprosthetic membrane
  • Kpro Lens Extrusion
  • Elevated intraocular pressure/glaucoma
  • Infectious endophthalmitis
  • Sterile vitritis
  • Retina detachment (rare) and
  • Vitreous hemorrhage (rare)
COMPLICATIONS
visual outcome

Multicenter Boston KPro Study is the largest published to date with 141 Boston type I keratoprosthesis procedures from 17 surgical sites by 39 different surgeons [.

  • At an average follow-up of 8.5 months, retention rate of the device was 95%, 57% had BCVA ≥ 20/200.
  • A large single surgeon series with 57 modern type I Boston KPro procedures from UCLA medical center [16]. At an average follow-up of 17 months, retention rate of the device was 84%, 75% had BCVA ≥ 20/200.
Visual outcome
visual outcome1

Post-Op visual improvement: after Singh-Worst KProIf the media is clear and IOP under control, patient can start seeing 6 hours after surgery. The visual results may vary anything between 6/9 to simply light perception. The average post-op VA is 6/36.

  • However, if the media is reasonably clear, a patient is quite happy being able to move around on his own if the health of the optic nerve is not a limiting factor. Prescription glasses also help in better visualization. Most of Singh-Worst KPro patients tend to require around +7.0D sphere.
Visual outcome
boston keratoprosthesis

The Boston Keratoprosthesis (Boston KPro) is a collar button design keratoprosthesis (Kpro)

  • It is composed of a front plate with a stem, which houses the optical portion of the device, a back plate and a titanium locking c-ring
Boston keratoprosthesis
osteo odonto kpro ookp

Osteo-odonto-keratoprosthesis (OOKP) (also known as "tooth in eye" procedure.

  • It includes removal of a tooth from the patient or a donor. After this, a lamina of tissue cut from the tooth is drilled and the hole is fitted with optics. The lamina is grown in the patients' cheek for a period of months and then is implanted upon the eye
Osteo-odontokpro (ookp)
alpha cor keratoprosthesis

Contains a peripheral skirt and a transparent central region. These two parts are connected on a molecular level by an interpenetrating polymer network, made from poly-2-hydroxyethyl methacrylate (pHEMA).

  • FDA-approved type of synthetic cornea measuring 7.0 mm in diameter and 0.5 mm in thickness.
  • main advantages of synthetic corneas are that they are biocompatible, and the network between the parts and the device prevents complications that could arise at their interface.
Alpha-corkeratoprosthesis
singh worst kpro
SINGH-WORST KPRO
  • Designed and developed in collaboration with Dr. Jan Worst in Netherlands and Dr. Daljit Singh in India.
  • Champagne-Cork Design for better stability.
  • one piece polycarbonate device
  • anterior surface has a diameter of 6.0mm
  • Shaft end diameter 4.5mm. Neck diameter 3.0 mm.
  • The flange has 8 equidistant holes near the margin.
keratoprosthesis at eye foundation hospital

4 KPro surgeries done so far since April 2010

  • All with Singh-Worst Kpro Lenses obtained from Dr Daljit Singh Amritsar North India
  • One lost to follow-up
  • One currently with VA LP
  • One with VA BCVA 6/36
  • Most recent case with BCVA 6/18
Keratoprosthesis at eye foundation hospital
left eye

The Most Recent Case:

  • 33yrs old man
  • Lost vision in both eyes from acid injury 2years ago
  • Developed cicatricial cornea lessions with extensive Ankylo- and Symblepharonin both eyes with VA of LP

RIGHT EYE

LEFT EYE
slide15

Had Symblepharon repair with superior and inferior fornix reformation and Singh-Worst Kpro Surgery in the Left eye -July 2012

  • BCVA now 6/18

8 DAY POST-OP

1 DAY POST-OP