Glaucoma Management in Patients With Aniridia and Boston Type 1 Keratoprosthesis

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art_SILVA_Glaucoma_Management_in_Patients_With_Aniridia_and_Boston_2019.PDF (368.23 KB)
Citações na Scopus
13
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCIENCE INC
Autores
SHEN, Lucy Q.
CHIOU, Carolina A.
SHANBHAG, Swapna S.
PASCHALIS, Eleftherios I.
PASQUALE, Louis R.
COLBY, Kathryn A.
LMAN, Claes H. Doh
CHODOSH, James
Citação
AMERICAN JOURNAL OF OPHTHALMOLOGY, v.207, p.258-267, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
PURPOSE: To assess outcomes and glaucoma management in eyes with aniridia following Boston type 1 Keratoprosthesis (KPro) implantation. DESIGN: Retrospective, interventional comparative case series. METHODS: The population included patients with aniridia and patients with other preoperative diagnoses (excluding Stevens-Johnson syndrome, mucous membrane pemphigoid, and congenital disorders) who underwent KPro implantation at Massachusetts Eye and Ear with at least 2 years of follow-up. One eye per patient was selected based on the longer follow-up time. The main outcome was intermediate and long-term outcomes related to glaucoma. RESULTS: The aniridia (n = 22) and comparison (n = 61) groups had similar preoperative visual acuity (VA, mean +/- standard deviation, 1.86 +/- 0.52 logMAR, P = .33) and follow-up time (65.6 +/- 26.3 months, P = .25). Before KPro implantation, eyes with aniridia had more glaucoma (76.2%) and glaucoma surgery (57.1%) than comparison eyes (51.8%, P = .053; 23.2%, P = .005, respectively). More Ahmed valves were co-implanted with KPro in aniridia (47.6%) vs comparison eyes (17.9%, P = .008). At final follow-up, more aniridia eyes had glaucoma (90.5%) than comparison eyes (64.3%, P = .02), but the 2 groups had similar percentages of eyes with cup-to-disc ratio (CDR) > 0.8 (23.8% vs. 30.4%, P = .57) or CDR progression of >= 0.2 (42.9% vs 44.6%, P = .89, respectively). None of the eyes with prophylactic tube implantation developed glaucoma. Eyes with and without aniridia did not differ in post-KPro VA improvement (72.7%, 72.1%, P = .96), and final VA (1.28 +/- 0.79 logMAR, 1.23 +/- 0.98 logMAR, P = .51). CONCLUSION: Despite a higher glaucoma prevalence, eyes with aniridia achieved similar VA as comparison eyes with more than 5 years of mean follow-up time. Boston KPro offers satisfactory visual rehabilitation in aniridia when glaucoma is managed aggressively.
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URI
https://observatorio.fm.usp.br/handle/OPI/34453
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MOF
Artigos e Materiais de Revistas Científicas - LIM/33