Mucosal Complications of Modified Osteo-odonto Keratoprosthesis in Chronic Stevens-Johnson Syndrome

Basu, Sayan; Pillai, Vinay S.; Sangwan, Veena

doi:10.1016/j.ajo.2013.06.012

Cited by 34 publications

(21 citation statements)

References 17 publications

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“…The authors had earlier reported a high, 63.3% mucosal complication rate in post-SJS eyes undergoing MOOKP implantation,12 possibly attributable to the bulk of the bony lamina and subclinical changes occurring in the oral mucosa attributable to the disease process. Mucosal problems were much less frequent in this series occurring in only 19% of eyes, which is statistically significant when compared with the incidence rate in MOOKP eyes, in comparable indications (p=0.0001, χ 2 test).…”

Section: Discussionmentioning

confidence: 99%

“…The MOOKP programme soon suffered from multiple setbacks including logistical problems, unacceptable cosmetic outcomes and multiple operating room visits for the patients not only for different stages of the procedure but also for the management of postoperative complications 12. The authors tried a variety of approaches to find an alternative to the MOOKP 15.…”

Section: Introductionmentioning

confidence: 99%

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LVP keratoprosthesis: anatomical and functional outcomes in bilateral end-stage corneal blindness

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

LVP keratoprosthesis: anatomical and functional outcomes in bilateral end-stage corneal blindness

et al. 2018

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“…Minor defects can be conservatively treated with increased lubrication and observation; the remaining can be tackled with a range of oculoplastic procedures like rotation flaps and free mucosal grafts. Basu et al 34 reported that patients with Stevens–Johnson syndrome have a high incidence of mucosal complications like ulceration and necrosis. They also proposed that a stepwise algorithm ranging from conservative approach to pedicle flaps could effectively treat these complications.…”

Section: Keratoprostheses: Current Challenges and Futurementioning

confidence: 99%

A brief review of Boston type-1 and osteo-odonto keratoprostheses

Avadhanam

Liu

2014

Br J Ophthalmol

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Globally there are ≈4.9 million bilaterally corneal blind and 23 million unilaterally corneal blind. Majority of this blindness exists in the developing countries, where resources for corneal banking and transplant surgery are less than adequate. Survival of corneal grafts gradually declines over the long term. Corneal transplantation has poor prognosis in vascularised corneal beds, ocular surface disease and viral keratitis. Keratoprosthesis (KPro) remains as a final option for end-stage ocular surface disease, multiple corneal transplant failures and high-risk corneal grafts. Boston type-1 KPro and osteo-odonto-keratoprosthesis are the two devices proven useful in recent years. Choice of a keratoprosthetic device is patient specific based on the underlying diagnosis, ocular morbidity and patient suitability. KPro surgery demands a high level of clinical and surgical expertise, lifelong commitment and extensive resources. Improvements in techniques and biomaterials may in the future provide retainable KPros that do not need regular follow-up of patients, have low complications but high retention rates and may be produced at a low cost on a mass scale to be available as 'off the shelf' devices. Because KPros have the potential to effectively address the burden of surgically treatable corneal blindness and may also eliminate the problems of corneal transplantation, more research is required to develop KPros as substitutes for corneal transplantation even in low-risk cases. In those countries where corneal blindness is a major liability, we need a two pronged approach: one to develop eye donation, eye banking and corneal transplantation and the second to establish centres for keratoprostheses, which are affordable and technically not challenging, in a population where default on follow-up visits are high. Until the latter is achieved, KPros should be viewed as a temporary means for visual restoration and be offered in national and supraregional specialised centres only.

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“…Initially, MOOKP was planned in the left eye for visual rehabilitation. Stage 1 of MOOKP3 including total iridectomy, intracapsular cataract extraction and anterior vitrectomy was performed in December 2011. Intraoperative fundus evaluation revealed a healthy disc and retina.…”

Section: Case Presentation Treatment and Outcomementioning

confidence: 99%

“…Conventional options like keratoplasty, limbal stem cell transplantation or Boston type 1 keratoprosthesis implantation seldom work in this scenario primarily because of the hostile nature of the ocular surface environment. The current treatment options include the modified osteo-odonto keratoprosthesis (MOOKP)1 or the Boston type 2 keratoprosthesis,2 each having their own limitations 2 3. This report highlights the innovative and successful use of Boston type 1 design-based keratoprosthesis (Auro Kpro, AuroLab, Madurai, India) and its modification (LVP Kpro) under an oral mucous membrane graft (MMG) in such severely diseased blind eyes.…”

Section: Introductionmentioning

confidence: 99%

Boston type 1 based keratoprosthesis (Auro Kpro) and its modification (LVP Kpro) in chronic Stevens Johnson syndrome

et al. 2014

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Two young women with completely dry and keratinised eyes post-Stevens Johnson Syndrome (SJS) underwent unilateral oral mucous membrane grafts (MMGs) in preparation for modified osteo-odonto keratoprosthesis (MOOKP) implantation. In both cases, the mucosal graft was deemed to be too tight to accommodate the MOOKP implant. Instead of proceeding with MOOKP, the first patient underwent Auro Kpro (Boston type 1-based keratoprosthesis) implantation under the MMG, while the second patient underwent implantation of a modification of Auro Kpro with a longer optical stem (LVP Kpro) exposed through the MMG. Both patients maintained a visual acuity of 20/20, N6 at 15 months post-implantation. The first patient needed repeated mucosal trimming because of mucosal overgrowth; while in the second patient, mucosal overgrowth did not occur. This report highlights the innovative and successful use of Boston type 1-based keratoprosthesis (Auro Kpro) and its modification (LVP Kpro) in completely dry and keratinised post-SJS eyes.

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Mucosal Complications of Modified Osteo-odonto Keratoprosthesis in Chronic Stevens-Johnson Syndrome

Cited by 34 publications

References 17 publications

LVP keratoprosthesis: anatomical and functional outcomes in bilateral end-stage corneal blindness

LVP keratoprosthesis: anatomical and functional outcomes in bilateral end-stage corneal blindness

A brief review of Boston type-1 and osteo-odonto keratoprostheses

Boston type 1 based keratoprosthesis (Auro Kpro) and its modification (LVP Kpro) in chronic Stevens Johnson syndrome

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