Abstract
The purpose of this study was to report a case of corneal dellen in a patient implanted with a Boston type 1 keratoprosthesis (KPro), which rapidly appeared after the loss of the large-diameter soft contact lens. This study is an observational case report of a 56-year-old man who underwent KPro implantation in his right eye in November 2010. In March 2014 during a follow-up visit, two areas of corneal dellen were observed. The patient had lost his bandage contact lens. With the application of a new soft contact lens, the thinned areas recovered completely within 5 days. After keratoprosthesis implantation, it is necessary to maintain uninterrupted wear of a bandage contact lens as it allows for adequate ocular surface hydration and prevents consequent complications. This case report highlights the need to provide proper instructions to such patients, in order to minimize the risk.
References
Dohlman CH, Harissi-Dagher M, Khan BF, Sippel K et al (2006) Introduction to the use of the Boston keratoprosthesis. Expert Rev Ophthalmol 1:41–48
Thomas M, Shorter E, Joslin CE et al (2015) Contact lens use in patients with Boston keratoprosthesis type 1: fitting, management, and complications. Eye Contact Lens 41(6):334–340
Pellegrini G, Rama P, Matuska S et al (2013) Biological parameters determining the clinical outcome of autologous cultures of limbal stem cells. Regen Med 8(5):553–567
Pellegrini G, Traverso CE, Franzi AT et al (1997) Long-term restoration of damaged corneal surfaces with autologous cultivated corneal epithelium. Lancet 349(9057):990–993
Robert MC, Dolman CH (2014) A review of corneal melting after Boston keratoprosthesis. Sem Ophthalmol 29(5–6):349–357
Greiner MA, Li JY, Mannis MJ (2011) Longer-term vision outcomes and complications with the Boston type 1 keratoprosthesis at the University of California, Davis. Ophthalmology 118(8):1543–1550
Maeda H, Okamoto T, Akaike T (1998) Human matrix metalloprotease activation by insults of bacterial infection involving proteases and free radicals. Biol Chem 379(2):193–200
Harissi-Dagher M, Khan BF, Schaumberg DA et al (2007) Importance of nutrition to corneal grafts when used as a carrier of the Boston keratoprosthesis. Cornea 26(5):564–568
Yaghouti F, Nouri M, Abad JC et al (2001) Keratoprosthesis: preoperative prognostic categories. Cornea 20(1):19–23
Chan CC, Holland EJ (2012) Infectious keratitis after Boston type 1 keratoprosthesis implantation. Cornea 31(10):1128–1134
Nau AC, Drexler S, Dhaliwal DK et al (2014) Contact lens fitting and long-term management for the Boston keratoprosthesis. Eye Contact Lens 40:185–189
Corrales RM, Stern ME, De Paiva CS et al (2006) Desiccating stress stimulates expression of matrix metalloproteinases by the corneal epithelium. Investig Ophthalmol Vis Sci 47(8):3293–3302
Li DQ, Chen Z, Song XJ et al (2004) Stimulation of matrix metalloproteinases by hyperosmolarity via a JNK pathway in human corneal epithelial cells. Investig Ophthalmol Vis Sci 45(12):4302–4311
Harissi-Dagher M, Beyer J, Dohlman CH (2008) The role of soft contact lenses as an adjunct to the Boston keratoprosthesis. Int Ophthalmol Clin 48:43–51
Khan B, Dudenhoefer EJ, Dohlman CH (2001) Keratoprosthesis: an update. Curr Opin Ophthalmol 14:282–287
Smiddy WE, Hamburg TR, Kracher GP et al (1990) Therapeutic contact lenses. Ophthalmology 97:291–295
Dohlman CH, Dudenhoefer EJ, Khan BF (2002) Protection of the ocular surface after keratoprosthesis surgery: the role of soft contact lenses. CLAO J Off Publ Contact Lens Assoc Ophthalmol Inc 28:72–74
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Scotto, R., Vagge, A. & Traverso, C.E. Corneal graft dellen in a patient implanted with a Boston keratoprosthesis type 1. Int Ophthalmol 37, 263–266 (2017). https://doi.org/10.1007/s10792-016-0227-2
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DOI: https://doi.org/10.1007/s10792-016-0227-2