Glaucoma Management in Patients With Aniridia and Boston Type 1 Keratoprosthesis

Silva, Rafaella Nascimento e; Shen, Lucy Q.; Chiou, Carolina A.; Shanbhag, Swapna S; Paschalis, Eleftherios I.; Pasquale, Louis R.; Colby, Kathryn; Dohlman, Claes H.; Chodosh, James; Alves, Mílton Ruiz

doi:10.1016/j.ajo.2019.06.018

Cited by 17 publications

(8 citation statements)

References 42 publications

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“…DSEK (Fig. 3B) 1-year survival rate was 75% with 95% CI [13,96] and decreased to 25% with 95% CI [1, 66] at 2 years. LK had 5year, 10-year, and 15-year survival rates of 88% with 95% CI [40, 99], 63% with 95% CI [23,87], and 31% with 95% CI [6, 64], respectively.…”

Section: Resultsmentioning

confidence: 99%

“…LK had 5year, 10-year, and 15-year survival rates of 88% with 95% CI [40, 99], 63% with 95% CI [23,87], and 31% with 95% CI [6, 64], respectively. LSCT showed a 1-year survival rate of 75% with 95% CI [13,96] and 5year survival rate of 25% with 95% CI [1,66]. Log-rank (Mantel Cox) analysis showed a signi cant difference between survival curves of the aforementioned corneal surgeries (p = 0.0006).…”

Section: Resultsmentioning

confidence: 99%

“…Keratoprosthesis (KPro) survival rate at 1-year, 5-years, and 10-years was 95% with 95% CI [70, 99] and 83% with 95% CI [55, 94] at 5-years, and 64% with 95% CI [32,84], respectively. B) Survival rates of limbal stem cell transplantation (LSCT) were 75% with 95% CI [13,96] at 1-year and 25% with 95% CI [1,66] at 5-years. Descemet stripping and endothelial keratoplasty (DSEK) 1-year survival rate was 75% with 95% CI [13,96] and decreased to 25% with 95% CI [1,66] at 2 years.…”

Section: Discussionmentioning

confidence: 99%

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Clinical outcomes and visual prognostic factors in congenital aniridia

Jacobson

Bohnsack

2022

Preprint

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Background: Evaluate outcomes and identify prognostic factors in congenital aniridia. Methods: Retrospective interventional case series of patients with congenital aniridia treated between 2012-2020. Ocular examination and surgical details were collected. Surgical failure was defined as disease progression or need for additional surgery for same/related indication. Kaplan-Meier survival curves, Wilcoxon test, and univariate and multivariate linear regression analyses were performed. Results: Ninety-four patients with congenital aniridia presented at median 19.0 years. Two-thirds of patients underwent > 1intraocular surgery, with average of 1.7 ± 2.3 surgeries/eye. At final follow-up (median 4.0 years), 45% of eyes had undergone lensectomy. Aphakic eyes showed worse visual acuity (VA) than phakic or pseudophakic eyes. Glaucoma affected 52% of eyes, of which half required IOP-lowering surgery. Glaucoma drainage devices showed the highest success rate (71%) at 14.2±15.4 years of follow-up. Keratopathy affected 65% of eyes and one-third underwent corneal surgery. Keratoprosthesis had the longest survival rates at 10-years (64% with 95% CI [32,84]). LogMAR VA at presentation and final follow-up were not statistically different. Half of patients were legally blind at final follow-up. Final VA was associated with presenting VA, glaucoma diagnosis, and cataract or keratopathy at presentation. Penetrating keratoplasty and keratoprosthesis implantation correlated with worse BCVA. Conclusions: Most aniridic patients in this large US-based cohort underwent at least 1 intraocular surgery. Cataract, glaucoma, and keratopathy were associated with worse VA and are important prognostic factors to consider when managing congenital aniridia.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical outcomes and visual prognostic factors in congenital aniridia

Jacobson

Bohnsack

2022

Preprint

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“…Glaucoma de novo was defined as progressive enlargement of the C / D ratio ≥ 0.2 from any prior postoperative visit [ 11 ]. IOP was measured preoperatively by Goldmann applanation tonometry or finger palpation and postoperatively by finger palpation and registered as the mean when a range was recorded.…”

Section: Methodsmentioning

confidence: 99%

Clinical Experience in Patients with Ocular Burns Treated with Boston Type I Keratoprosthesis Implantation with or Without Prophylactic Ahmed Glaucoma Valve Implantation

Zhang

Zhai

et al. 2021

Ophthalmol Ther

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Introduction To compare outcomes in eyes with ocular burns following Boston Type I keratoprosthesis (KPro) implantation with and without prophylactic pars plana tube surgery. Methods A retrospective review of patients with ocular burns who underwent KPro surgery at Zhongshan Ophthalmic Center was performed. Twenty-six eyes of 26 patients without a preoperative diagnosis of glaucoma before KPro surgery met the inclusion criteria. Preoperative glaucoma was defined as a history of a durable elevated intraocular pressure (IOP) ≥ 25 mmHg at different time points, which resulted in the introduction of anti-glaucoma medication or surgical intervention. Sixteen eyes underwent KPro alone (Group 1), and 10 eyes received KPro with prophylactic pars plana tube surgery (Group 2). Results Group 1 and Group 2 were similar in the proportions of the ocular burn type and preoperative clock hours of peripheral anterior synechiae by ultrasound biomicroscopy (1.88 ± 1.63 vs. 2.30 ± 1.83; P = 0.54). Before KPro surgery, 62.5% of eyes in Group 1 and 50.0% of eyes in Group 2 had intraocular surgeries ( P = 0.53). The follow-up time was 18 months. At the final follow-up time, the two groups had similar visual acuity (1.34 ± 0.87 logMAR, 1.03 ± 0.71 logMAR; P = 0.35) and eyes with a C / D ratio ≥ 0.8 (7/16, 2/10; P = 0.21), but more eyes in Group 1 developed glaucoma de novo than eyes in Group 2 (62.5%, 20%; P = 0.04) and had undergone secondary glaucoma surgery after KPro implantation (7/16 vs. 0/10; P = 0.02). Conclusion In eyes injured with ocular burns, KPro implantation with prophylactic pars plana tube surgery may be a feasible option to rehabilitate visual acuity and decrease the incidence of glaucoma de novo.

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“…Extrapolated values of 2.0, 2.3, 2.6 represented BCVA of counting fingers, hand motion, and light perception, respectively. 46,47 IOP was measured by digital palpation by a single experienced clinician (M.H.-D.) by using scleral indentation felt by the finger and then assessing the IOP. The mean of an estimated range was recorded, as commonly performed in KPro eyes.…”

Section: Clinical Examinationmentioning

confidence: 99%

Tear Film Cytokine Profile of Patients With the Boston Keratoprosthesis Type 1: Comparing Patients With and Without Glaucoma

Geoffrion

Robert

Polo

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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Inflammatory cytokines are involved in glaucoma pathogenesis. The purpose is to compare cytokine levels in the tear film of Boston keratoprosthesis (KPro) patients with and without glaucoma, relative to controls, and correlate levels with clinical parameters. METHODS.This cross-sectional study enrolled 58 eyes (58 patients): 41 KPro eyes with glaucoma, 7 KPro eyes without glaucoma, and 10 healthy controls. Twenty-seven cytokines were measured by multiplex bead immunoassay. Intraocular pressure (IOP), cup-to-disk ratio (CDR), retinal nerve fiber layer, visual acuity, topical medications, and angle closure were assessed in all KPro eyes. Cytokine levels between groups were analyzed by nonparametric tests, and correlations with clinical parameters by Spearman's test. RESULTS.Levels of TNF-ɑ, IL-1β, FGF-basic, and IFN-ɣ were significantly higher in KPro with glaucoma compared to KPro without (P = 0.020; 0.008; 0.043; 0.018, respectively). KPro groups had similar characteristics and topical antibiotic/steroid regimen. Levels of IL-1Ra, IL-15, VEGF, and RANTES were significantly higher in KPro with glaucoma compared to controls

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Glaucoma Management in Patients With Aniridia and Boston Type 1 Keratoprosthesis

Cited by 17 publications

References 42 publications

Clinical outcomes and visual prognostic factors in congenital aniridia

Clinical outcomes and visual prognostic factors in congenital aniridia

Clinical Experience in Patients with Ocular Burns Treated with Boston Type I Keratoprosthesis Implantation with or Without Prophylactic Ahmed Glaucoma Valve Implantation

Tear Film Cytokine Profile of Patients With the Boston Keratoprosthesis Type 1: Comparing Patients With and Without Glaucoma

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