Abstract
Prior to keratoprosthesis implantation, evaluation of anterior segment anatomy is of vital importance to ensure adequate space for the implant. In many cases, corneal opacity prevents direct examination of the anterior segment. In these cases, ancillary imaging studies such as anterior segment optical coherence tomography (OCT) or ultrasound biomicroscopy (UBM) are required for thorough evaluation. Important variables in anterior chamber anatomy include anterior chamber depth, phakic status, presence of synechial angle closure or iris-cornea touch, and location of any hardware such as a glaucoma drainage implant (GDI). These factors aid in the selection of a keratoprosthesis model and can indicate the necessity for additional procedures such as intraocular lens removal or GDI repositioning. Special considerations must be made in pediatric keratoprosthesis given the naturally shallow anterior chamber and in the presence of anterior segment malformations.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Ciralsky J, Papaliodis GN, Foster CS, Dohlman CH, Chodosh J. Keratoprosthesis in autoimmune disease. Ocul Immunol Inflamm. 2010;18:275–80.
Dohlman CH, Harissi-Dagher M. The Boston keratoprosthesis: a new threadless design. Digit J Ophthalmol. 2007;13:3. http://www.djo.harvard.edu/site.php?url=/physicians/oa/1055. Accessed 28 Apr 2013.
Abbasian J, Cortina MS, de la Cruz J. Use of preoperative imaging for surgical planning in patients undergoing Boston keratoprosthesis type 1. Techniques in Ophthalmology 2011;9(3):71–3.
Vajaranant TS, Blair MP, McMahon T, Wilensky JT, de la Cruz J. Special considerations for pars plana tube-shunt placement in Boston Type 1 keratoprosthesis. Arch Ophthalmol. 2010;128:1480–2.
Aquavella JV, Gearinger MD, Akpek EK, McCormick GJ. Pediatric keratoprosthesis. Ophthalmology. 2007;114:989–94.
External disease and cornea, Section 8. Basic and clinical science course. San Francisco: American Academy of Ophthalmology; 2011.
Nallasamy S, Colby K. Keratoprosthesis: procedure of choice for corneal opacities in children? Semin Ophthalmol. 2010;25:244–8.
Colby KA, Koo EB. Expanding indications for the Boston keratoprosthesis. Curr Opin Ophthalmol. 2011;22:267–73.
Cauduro RS, Ferraz CA, Morales MS, et al. Application of anterior segment optical coherence tomography in pediatric ophthalmology. J Ophthalmol. 2012;2012:313120. Epub 2012 Aug 9.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Sivaraman, K.R., Allemann, N. (2015). Anterior Segment Considerations in Boston Type I Keratoprosthesis. In: Cortina, M., de la Cruz, J. (eds) Keratoprostheses and Artificial Corneas. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55179-6_4
Download citation
DOI: https://doi.org/10.1007/978-3-642-55179-6_4
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-55178-9
Online ISBN: 978-3-642-55179-6
eBook Packages: MedicineMedicine (R0)