Boston Keratoprosthesis Type I: Surgical Techniques

2014 ◽  
pp. 77-80
Author(s):  
Lauren R. Schneider ◽  
Sadeer B. Hannush
Keyword(s):  
Surgical Techniques ◽  
Type I ◽  
Boston Keratoprosthesis

scholarly journals Muscle Changes in Lambs with Surgically Created Scoliosis Produced in Utero

1978 ◽  
Vol 5 (3) ◽  
pp. 283-287 ◽  
Author(s):  
G.M. Kent ◽  
W. Zingg ◽  
D. Armstrong
Keyword(s):  
Musculoskeletal Diseases ◽  
Fiber Type ◽  
Surgical Techniques ◽  
Spinal Curvature ◽  
Surgical Trauma ◽  
Developmental Defect ◽  
Type I ◽  
Type Ii ◽  
Muscle Changes ◽  
Type Ii Fibers

SUMMARY:Spinal curves may be produced in fetal lambs with three surgical techniques. These procedures vary from mere exposure of the costo-vertebral junction of three ribs through a paravertebral incision, to resection of the head and part of the adjacent shaft of three ribs. The fetal age varies from forty-nine to seventy-three days. The degree of curvature present at birth seems to increase in severity with decreasing fetal age at the time of surgery, but the type of surgical procedure does not appear to influence the severity of the curve, suggesting that the mechanical presence of the ribs does not prevent the development of scoliosis in these animals.Histological studies of the m. longissimus dorsi at the apices of the curves reveal two main types of abnormality in the muscle fibers. Both Type I and Type II fibers were significantly reduced in size in the biopsies taken from the side on which the surgery was performed, and there was marked alteration in the proportion of one fiber type to the other in most biopsies taken from both operated sides when compared with biopsies from unoperated twin animals.The fetal age and amount of surgical trauma appeared to play no role in the degree of muscle alteration, suggesting that even minimal surgical trauma to the paraspinal region at any fetal age between 49–73 days is sufficient to produce significant muscle fiber abnormality and spinal curvature.A parallel is drawn between these muscle findings and those in a number of human musculoskeletal diseases, and suggests the possibility of a developmental defect in the pathogenesis of these diseases.

scholarly journals Errata: Advantages of microscope-integrated intraoperative online optical coherence tomography: usage in Boston keratoprosthesis type I surgery

2016 ◽  
Vol 21 (2) ◽  
pp. 029801 ◽  
Author(s):  
Sebastian Siebelmann ◽  
Philipp Steven ◽  
Deniz Hos ◽  
Gereon Hüttmann ◽  
Eva Lankenau ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Type I ◽  
Optical Coherence ◽  
Boston Keratoprosthesis

Long-term outcomes of Boston keratoprosthesis type I: the Chinese People’s Liberation Army General Hospital experience

2021 ◽  
pp. bjophthalmol-2019-315617
Author(s):  
Li-Qiang Wang ◽  
Teng-Yun Wu ◽  
Xiao-Niao Chen ◽  
Ze-Quan Xu ◽  
Min Yang ◽  
...  
Keyword(s):  
General Hospital ◽  
Ocular Surface ◽  
Retention Rate ◽  
Case Series ◽  
Type I ◽  
Long Term Outcomes ◽  
Boston Keratoprosthesis ◽  
People's Liberation Army ◽  
People’S Liberation Army

PurposeTo report the long-term outcomes of Boston keratoprosthesis type I (B-KPro type I) implantation in the management of severe ocular surface disorders.MethodsRetrospective case series. Patients who underwent B-KPro type I implantation at the People’s Liberation Army General Hospital were enrolled between March 2011 and September 2019. Data regarding visual acuity (VA), B-KPro type I retention and postoperative complications were recorded and analysed.ResultsA total of 103 eyes of 100 patients who underwent B-KPro type I implantation were included. The main indications were chemical burn (59.2%), ocular trauma (25.2%), herpetic keratitis (11.7%) and autoimmune diseases (3.9%). The percentage of eyes with postoperative VA of 10/200 or better was 82.7% at 6 months, 82.8% at 12 months, 77.9% at 2 years, 72.4% at 3 years, 71.1% at 4 years, 69.4% at 5 years, 58.9% at 6 years, 56.8% at 7 years and 42.9% at 8 years. Preoperatively, 8.7% eyes were diagnosed with new-onset glaucoma. Retroprosthetic membrane formation occurred in 19.4% eye. Corneal melting occurred in 18.4% eyes. Sterile vitritis was diagnosed in 4.9% eyes and infectious endophthalmitis in 2.9% eyes. Retinal detachment occurred in 0.9% eyes.ConclusionsIn a Chinese patient group, B-KPro type I is a viable option for treating severe ocular surface disorders in eyes where conventional keratoplasty would have a poor prognosis, especially in patients with chemical and thermal burns. Improved visual outcomes and high retention rate can be achieved and maintained in most cases.

Visual Outcomes and Complications of Type I Boston Keratoprosthesis in Children

Ophthalmology ◽  
2018 ◽  
Vol 125 (2) ◽  
pp. 153-160 ◽  
Author(s):  
Simon S.M. Fung ◽  
Samir Jabbour ◽  
Mona Harissi-Dagher ◽  
Reginald R.G. Tan ◽  
Patrick Hamel ◽  
...  
Keyword(s):  
Type I ◽  
Boston Keratoprosthesis ◽  
Visual Outcomes

scholarly journals Surgery at Cranio-vertebral (CV) Junction: Our Experience of 32 Cases

1970 ◽  
Vol 29 (2) ◽  
pp. 78-84
Author(s):  
FH Chowdhury ◽  
MR Haque ◽  
NKSM Chowdhury ◽  
MS Islam ◽  
Z Raihan ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Surgical Techniques ◽  
Clinical Findings ◽  
Type I ◽  
College Hospital ◽  
Chiari Malformation Type I ◽  
Female Ratio ◽  
Medical College ◽  
Neoplastic Lesion ◽  
Wide Range

Cranio vertebral (CV) junction is one of the critical sites for surgery. It's anatomy, physiological aspects and pathological involvement varies in a wide range of margins. Common problems are developmental anomalies, traumatic involvement, inflammatory, infective and neoplastic lesion. Management of these problems varies a lot from each other. Aim of the article is to overview the pathologies in this area and to study presentations, investigations, surgical procedures and results of these pathologies. We prospectively analyzed 32 cases of Cranio-vertebral (CV) region surgery in the Department of Neurosurgery Dhaka Medical College Hospital and Mitford Hospital, Dhaka, from 2000 to 2008. In our series, male and female ratio was 7.2:1. Pathologies were atlanto- axial dislocation (AAD), Chiari malformation type –I, schwannoma, meningioma, hydatid cyst and tuberculosis. Common clinical findings were- neck pain, quadriparesis, quadriplegia, hand atrophy, autonomic dysfunction and hypertension. Various types of surgical procedures were done in this series according to the pathology. Death was in 01 case, neurological deterioration seen in one case, 2 cases were neurologically stable and 28 cases (87.5%) improved neurologically where one was non useful improvement (Frankel grade-C). Complete pre operative radiological study is a very important adjunct for a successful surgical result. Proper evaluation of patients with selection of appropriate surgical procedures along with safe surgical techniques are the necessary things for successful surgery in this area. DOI: http://dx.doi.org/10.3329/jbcps.v29i2.7952 (J Bangladesh Coll Phys Surg 2011; 29: 78-84)

FM1-5 The impact of neurosurgical technique on outcome of adult patients with chiari I malformation

2019 ◽  
Vol 90 (3) ◽  
pp. e22.1-e22
Author(s):  
SM McAllister ◽  
P Gallo
Keyword(s):  
Hospital Stay ◽  
Surgical Techniques ◽  
Chiari I Malformation ◽  
Type I ◽  
Chiari Malformation Type I ◽  
Radiological Criteria ◽  
Complication Risk ◽  
Lower Complication ◽  
Dural Opening ◽  
The Impact

ObjectivesThis study aimed to compare and evaluate any differences in clinical and radiological outcomes between three surgical techniques of cranio-cervical decompression (CCD) in adults with symptomatic Chiari malformation type I (CM1).DesignRetrospective review using the theatre management system (ORSOS) and records of the patients who underwent CCD for CM1 from January 2011 to January 2018.SubjectsPatients over 16 years of age who underwent CCD secondary to CM1 diagnosed by clinical and radiological criteria.MethodsPatients were divided in three cohorts according the operative technique used: an extradural osteo-ligamentous decompression (BD), BD plus dural opening either without duroplasty (DOWD) or with watertight augmentative duroplasty (DOPD). The primary clinical outcome was measured by utilizing the Chicago Chiari Outcome Scale (CCOS). Syrinx outcome was measured on post-op MRI. Statistical analysis was performed using IBM SPSS 24 with α=0.05.ResultsFifty-two adults underwent fifty-three CCD: 7 BD, 29 DOWD, 17 DOPD. Median follow-up was 12 months (IQR 6–23). Patients who underwent BD or DOPD had a shorter median hospital stay (6 days) than DOWD (11 days). Median CCOS was lower following DOWD (13) compared to BD (14) and DOPD (15). Post-operative complications were higher in DOWD (51.7%) compared to DOPD (17.5%).ConclusionsBetter clinical outcomes, lower complication risk and shorter duration of hospital stay were associated with DOPD. Prospective randomized studies could confirm these findings.

Mid-term prognosis of type I Boston keratoprosthesis reimplantation

2020 ◽  
pp. bjophthalmol-2020-317598
Author(s):  
Soumaya Bouhout ◽  
Marie-Claude Robert ◽  
Mona Harissi-Dagher
Keyword(s):  
Retinal Detachment ◽  
Retention Rate ◽  
Case Series ◽  
Type I ◽  
Light Perception ◽  
Visual Rehabilitation ◽  
Boston Keratoprosthesis ◽  
Kaplan Meier ◽  
Primary Endpoints ◽  
One Year

AimTo examine the mid-term visual and anatomical prognosis of patients who require reimplantation of a second Boston keratoprosthesis type 1 (B-KPro).MethodsRetrospective observational case series of 122 patients (141 eyes) who received a B-KPro at a single institution were reviewed. Eyes that underwent a second B-KPro were included in the study. Primary endpoints were B-KPro retention, final visual acuity 20/200 and loss of light perception. Secondary endpoints included the occurrence of postoperative complications.ResultsSeventeen eyes (12%) required a B-KPro reimplantation. Corneal melt was the most common indication for replacement (88%). Mean follow-up time after the second B-KPro was 4.4±2.1 years. The Kaplan-Meier analysis estimated the second B-KPro retention rate at 79% over 8 years. Retroprosthetic membrane (RPM, 53%) was the most common complication. Forty-one per cent of the eyes suffered from corneal melt following their second B-KPro. One year after the second B-KPro, 47% of the patients retained a vision 20/200. Seven eyes (41.2%) lost light perception, which was secondary to an inoperable retinal detachment in five cases. Four eyes (24%) developed phthisis following inoperable retinal detachment (n=3) or endophthalmitis (n=1).ConclusionB-KPro reimplantation is a potentially sight- and globe-saving procedure for eyes with B-KPro failure, but the prognosis is guarded. B-KPro reimplantation can salvage ambulatory vision in a third of patients while another third of patients progress to loss of light perception. RPM and retinal detachment were important obstacles to visual rehabilitation while recurrent corneal melt was responsible for most cases of anatomical failure.

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