TY - JOUR
T1 - Predictors of visual outcomes following boston type 1 keratoprosthesis implantation
AU - Ahmad, Sumayya
AU - Akpek, Esen K.
AU - Gehlbach, Peter L.
AU - Dunlap, Karen
AU - Ramulu, Pradeep Y.
N1 - Funding Information:
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Ramulu received payment for lectures from Carl Zeiss Meditech and has a grant from the National Eye Institute for which The Wilmer Eye Institute received remuneration. Dr Akpek is an unpaid member of the board of the Sjogren's Syndrome Foundation and Tissue Banks International; she has received payment for consultancy with GlaxoSmithKline and has a grant with Allergan for which the Wilmer Institute received funding. Dr Gehlbach received grants from the NIH and from the Blind Industries and Services of Maryland with personal remuneration. This study was supported in part by a grant from Research to Prevent Blindness with the Robert and Helen Schaub Special Scholar Award, New York, New York (Dr Ramulu). Contributions of authors: involved in the design of the study (S.A., E.K.A., P.Y.R.); conduct of the study (S.A., P.Y.R.); collection, management, analysis, and interpretation of data (S.A., K.D., P.Y.R., E.K.A.); and preparation, review, or approval of the manuscript (S.A., K.D., P.Y.R., E.K.A., P.L.G.).
Publisher Copyright:
© 2015 Elsevier Inc. All Rights Reserved.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Purpose To identify predictors of visual outcomes following Boston type 1 Keratoprosthesis (KPro) implantation. Design Retrospective chart review. Methods Data regarding preoperative clinical and demographic characteristics and postoperative course were collected. patients: Fifty-nine eyes of 59 adult patients who underwent KPro implantation between January 2006 and March 2012 at a single tertiary care center. main outcome measures: Preoperative factors associated with all-cause and glaucoma-related loss of visual acuity from the best postoperative visual acuity noted. Results Fifty-two of 59 eyes (88%) achieved improved vision post implantation, with 7 eyes failing to gain vision as a result of pre-existing glaucoma (n = 4) or retino-choroidal disease (n = 3). Twenty-one eyes (21/52, 40%) maintained their best-ever visual acuity at last visit (mean follow-up period was 37.8 months). The likelihood of maintaining best-ever vision was 71% at 1 year, 59% at 2 years, and 48% at 3 years. Primary KPro implantation was associated with a higher likelihood of losing best-ever vision as compared to KPro implantation as a repeat corneal procedure (hazard ratio [HR] = 3.06; P = 006). The main reasons for postimplantation vision loss was glaucoma (12/31, 39%), and the risk of glaucomatous visual acuity loss was 15% at 2 years and 27% at 3 years. Prior trabeculectomy was associated with a higher rate of vision loss from glaucoma (HR = 3.25, P =.04). Conclusion Glaucoma is the primary reason for loss of visual acuity after KPro implantation. Conditions necessitating primary KPro surgery are associated with more frequent all-cause vision loss. Prospective trials are necessary to better determine which clinical features best predict KPro success.
AB - Purpose To identify predictors of visual outcomes following Boston type 1 Keratoprosthesis (KPro) implantation. Design Retrospective chart review. Methods Data regarding preoperative clinical and demographic characteristics and postoperative course were collected. patients: Fifty-nine eyes of 59 adult patients who underwent KPro implantation between January 2006 and March 2012 at a single tertiary care center. main outcome measures: Preoperative factors associated with all-cause and glaucoma-related loss of visual acuity from the best postoperative visual acuity noted. Results Fifty-two of 59 eyes (88%) achieved improved vision post implantation, with 7 eyes failing to gain vision as a result of pre-existing glaucoma (n = 4) or retino-choroidal disease (n = 3). Twenty-one eyes (21/52, 40%) maintained their best-ever visual acuity at last visit (mean follow-up period was 37.8 months). The likelihood of maintaining best-ever vision was 71% at 1 year, 59% at 2 years, and 48% at 3 years. Primary KPro implantation was associated with a higher likelihood of losing best-ever vision as compared to KPro implantation as a repeat corneal procedure (hazard ratio [HR] = 3.06; P = 006). The main reasons for postimplantation vision loss was glaucoma (12/31, 39%), and the risk of glaucomatous visual acuity loss was 15% at 2 years and 27% at 3 years. Prior trabeculectomy was associated with a higher rate of vision loss from glaucoma (HR = 3.25, P =.04). Conclusion Glaucoma is the primary reason for loss of visual acuity after KPro implantation. Conditions necessitating primary KPro surgery are associated with more frequent all-cause vision loss. Prospective trials are necessary to better determine which clinical features best predict KPro success.
UR - http://www.scopus.com/inward/record.url?scp=84924778263&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84924778263&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2014.12.024
DO - 10.1016/j.ajo.2014.12.024
M3 - Article
C2 - 25555801
AN - SCOPUS:84924778263
SN - 0002-9394
VL - 159
SP - 739-747.e1
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 4
ER -