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Choices exist for ocular surface reconstruction cases
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SAN DIEGO — Both ocular surface transplantation and keratoprosthesis were shown to be successful methods for ocular surface reconstruction, with patient choice highly dependent on individual cases, according to a physician here.
"The question is not which technique is better, but rather which technique is best indicated for this patient," Edward J. Holland, MD, OSN Cornea/External Disease Board Member, said at Cornea Day preceding the American Society of Cataract and Refractive Surgery meeting.
Each method has its own indications and complications, Dr. Holland said. Ocular surface transplantation is best suited for patients with severe conjunctival disease; keratoprosthesis is best indicated for patients at high risk of corneal graft failure from immunologic or endothelial complications.
Disadvantages to ocular surface transplantation include the likely need for staged keratoplasty and potential failure for subsequent keratoplasty, as well as the need for a near-perfect ocular surface to produce good visual outcomes. Keratoprosthesis requires only a single procedure, and a poor ocular surface may not interfere with the patient's overall vision quality. However, the procedure requires lifelong follow-up and use of topical antibiotics.
Surgeons should familiarize themselves with each procedure and the techniques necessary for complication management, Dr. Holland said.
- Disclosure: No products or companies are mentioned that would require financial disclosure.