Sergio Kwitko, Andressa P. Stolz, Melissa Dal Pizzol, Diane Marinho, Samuel Rymer

Ophthalmology Department - Hospital de Clínicas de Porto Alegre

Federal University of Rio Grande do Sul - Porto Alegre - Brazil

The authors have no financial interest in the subject matter of this poster

Experience with Dohlman-Doane Experience with Dohlman-Doane keratoprosthesis: case reportskeratoprosthesis: case reports

PurposePurpose

• To describe 14 eyes of 13

patients who had received

Dohlman-Doane type 1

Keratoprostesis (Kpro) with a

mean follow-up of 25.5 months

(range, 1 to 49 months).

MethodsMethods• A retrospective, noncomparative interventional case series.• Previous corneal disease was:

– bilateral alkaline burn (5 eyes)– multiple graft failure (6 eyes)– Stevens-Johnson Syndrome (2 eyes)– thermal injury (1 eye)

• Best corrected spectacle visual acuity (BSCVA) was hand motions or worse in all eyes.

• Glaucoma was present in 3 eyes preoperatively and received Ahmed valve implantation.

• Post operative care is the same of conventional penetrating keratoplasty, added with continuous therapeutic contact lens, medroxiprogesterone and antibiotic drops.

ResultsResults

• 64% of eyes achieved BSCVA of ≥ 20/100 and 42.8% ≥ 20/40 (see table 1). In these eyes, post operative visual field was stable, in 30-50º.

• Complications:– 6 eyes: posterior capsule opacification treated with YAG laser

capsulotomy; – 5 eyes: corneal necrosis (4 treated with donor cornea bottom exchange);– 3 eyes: retroprosthetic membrane treated with tPA injection;– 2 eyes: vitreitis treated with posterior vitrectomy;– 1 eye: fungal keratitis (ended with post traumatic inoperable retinal

detachment);– 1 eye: fusarium endophthalmitis, treated with corneal transplant,

anterior vitrectomy, Kpro and intraocular lens explantation, as well as specific intravitreal and endovenous treatment.

– 1 eye: eviscerated after irreversible phthisis bulbi occurrence.

Figure 1. Patient 2: Pre(A) and 15 months post K-Pro(B)A B

Table 1: Cases that received Keratoprosthesis implantation

ConclusionConclusion

• Dohlman Kpro seems to be a good option for cases in witch penetrating keratoplasty contraindications.

• Advantages: • does not need systemic

immunossupression • good visual outcome.

• Best results were achieved in non-immune diseases.

ReferencesReferences1. Ma JJ, Graney JM, Dohlman CH. Repeat penetrating keratoplasty versus the Boston

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1996;15:179.4. Zerbe BL, Belin MW, Ciolino JB. Results from the multicenter Boston Type 1

Keratoprosthesis Study. Ophthalmology 2006;113:1779.5. Bradley JC, Hernandez EG, Schwab IR, Mannis MJ. Boston type 1 keratoprosthesis: the

university of california davis experience. Cornea 2009;28:321.6. Sayegh RR, Ang LP, Foster CS, Dohlman CH. The Boston keratoprosthesis in Stevens-

Johnson syndrome. Am J Ophthalmol 2008; 145:438.7. Barnes SD, Dohlman CH, Durand ML. Fungal colonization and infection in Boston

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