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Pyron Award Lecture: Boston KPro offers opportunities and challenges
SAN FRANCISCO — The Boston keratoprosthesis is a promising treatment for patients with corneal disease, but it does present challenges, a speaker told colleagues at the American Society of Retina Specialists annual meeting here.
Giving the Pyron Award Lecture, Donald J. D’Amico, MD, discussed opportunities and challenges faced by vitreoretinal surgeons concerning keratoprostheses and complex ocular reconstruction.
Donald J. D'Amico
The KPro is most suitable for patients with a failed corneal transplant, chemical burn or Stevens-Johnson syndrome, according to D’Amico, a professor of ophthalmology at Weill Cornell Medical College in New York.
“Recent data suggest that KPro compares quite favorably compared to doing a repeat penetrating keratoplasty in many eyes. In fact, it’s probably the way to go, even after a single failed corneal transplantation,” D’Amico said.
The most common KPro complication is retroprosthetic membrane, D’Amico said.
“About half of the devices will develop this at one time or another. You can often YAG it if it’s early, but very often you wind up with vitrectomy,” he said.
Other complications include sterile inflammation, endophthalmitis and posterior vitreous detachment.
Glaucoma tube placement causes profound hypotony in some KPro patients, D’Amico said.
“We are rethinking and becoming skeptical about implanting a glaucoma tube on every patient,” he said. – by Matt Hasson and Patricia Nale, ELS
Reference:
D’Amico DJ. Permanent keratoprosthesis and complex ocular reconstruction: new opportunities and challenges for the vitreoretinal surgeon. Presented at: American Society of Retina Specialists annual meeting; Aug. 9-14, 2016; San Francisco.
Disclosure: D’Amico reports no relevant financial disclosures.