Predictors of visual outcomes following boston type 1 keratoprosthesis implantation

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)739-747
Number of pages9
JournalAmerican Journal of Ophthalmology
Volume159
Issue number4
DOIs
StatePublished - Apr 1 2015

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Glaucoma
Visual Acuity
Choroid Diseases
Trabeculectomy
Tertiary Care Centers
Demography
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology
  • Medicine(all)

Cite this

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title = "Predictors of visual outcomes following boston type 1 keratoprosthesis implantation",
abstract = "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.",
author = "Sumayya Ahmad and Akpek, {Esen K} and Peter Gehlbach and Karen Dunlap and Pradeep Ramulu",
year = "2015",
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T1 - Predictors of visual outcomes following boston type 1 keratoprosthesis implantation

AU - Ahmad, Sumayya

AU - Akpek, Esen K

AU - Gehlbach, Peter

AU - Dunlap, Karen

AU - Ramulu, Pradeep

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.

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