Delayed Boston Keratoprosthesis Exchange due to a Preceding Vitreoretinal Surgery with Intraoperative Choroidal Detachment

Purpose: The aim is to describe the main characteristics of an anterior/posterior segment surgery and how to resolve intraoperative complications. Setting/Venue: The anterior and posterior segment surgical video was created at the Department of Ophthalmology, Virgin Macarena University Hospital, Seville, Spain. Methods: We present the case of a male with Stevens-Johnson syndrome and severe limbal deficiency who needed a Boston type 1 keratoprosthesis, reaching a visual acuity of 0.4 (0.05 before surgery). In the course of follow-up, he developed corneal melting with perforation, immune vitritis, and a large epimacular membrane. We decided to perform a 23-gauge vitrectomy associated with keratoprosthesis exchange. As a consequence of inappropriate anesthesia, the patient woke up during the surgery, provoking a retinal tear besides a choroidal detachment. These damages needed endolaser photocoagulation as well as silicone oil tamponade, forcing us to postpone the exchange. An intravitreal dexamethasone implant was also injected. Two months later, the silicone oil was removed, and the Boston keratoprosthesis was replaced by a new type 1 model with a titanium back plate, which likely improves biocompatibility and retention and may reduce complications such as retroprosthetic membranes and stromal corneal melts. Results: Good anatomical results were achieved, and visual acuity slightly improved to 0.2. Conclusions: Combined anterior and posterior segment surgery represents a great challenge that can improve not only visual acuity but also quality of life in patients with severe diseases such as Stevens-Johnson syndrome.

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Preventable Blindness due to Ankyloblepharonin Stevens- Johnson SyndromeA Case Report

BIRDEM Medical Journal ◽

10.3329/birdem.v6i2.31300 ◽

2017 ◽

Vol 6 (2) ◽

pp. 136-138

Author(s):

Manash Kumar Goswami ◽

Md Asaduzzaman

Keyword(s):

Case Report ◽

Dry Eye ◽

Stevens Johnson Syndrome ◽

Bulbar Conjunctiva ◽

Ocular Complications ◽

Johnson Syndrome ◽

Department Of Ophthalmology ◽

Corneal Opacities ◽

Preventable Blindness

Stevens-Johnson syndrome (SJS) is common, having long term ocular complications ranging from dry eye to loss of vision due to ankyloblepharon or corneal opacities. Proper medical management and separating the bulbar conjunctiva from palpebral regularly by a glass rod during the acute phaseof the diseases can prevent the development of ankyloblepharonand symblepharon. Here we present a case of ankyloblepharon after SJS which was repaired after 6 months in the department of ophthalmology, BIRDEM General Hospital.Birdem Med J 2016; 6(2): 136-138

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The Stevens-Johnson Syndrome* *From the Department of Ophthalmology, Massachusetts Eye and Ear Infirmary. This study was supported by the Edwin B. Dunphy Testimonial Fund. Presented before the New England Ophthalmological Society, Boston, November 21, 1962.

American Journal of Ophthalmology ◽

10.1016/0002-9394(63)90366-0 ◽

1963 ◽

Vol 55 (5) ◽

pp. 893-900 ◽

Cited By ~ 53

Author(s):

George M. Howard

Keyword(s):

New England ◽

Stevens Johnson Syndrome ◽

Johnson Syndrome ◽

Department Of Ophthalmology

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A Clinical Study of Visual Outcome after Nd YAG Laser Capsulotomy

Medicine Today ◽

10.3329/medtoday.v33i2.56052 ◽

2021 ◽

Vol 33 (2) ◽

pp. 98-101

Author(s):

Md Abdul Matin ◽

Mahbubur Rahman Shahin ◽

Zakia Farhana ◽

Sajed Abdul Khaleque

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Surgical Complication ◽

Posterior Segment ◽

Posterior Capsular Opacification ◽

Functional Score ◽

Posterior Chamber ◽

College Hospital ◽

Yag Laser ◽

Department Of Ophthalmology

Introduction: Posterior capsular opacification is caused by migration and proliferation of cuboidal epithelium from remnant of anterior capsule and equatorial part of the lens capsule. Posterior capsular opacification also called after cataract is a nagging post surgical complication following phacoemulsification or non phaco cataract surgery (small incision cataract surgery or conventional cataract surgery) ECCE with posterior chamber intraocular lens implantation. Posterior capsular opacification is actually misnomer. Though there are many factors suggested to reduced posterior capsular opacification. The incidence of PCO still exists considerably. Aims and Objective are to find out the visual improvement after Nd yag laser posterior capsulotomy. Materials and Methods: The prospective study was conducted in the department of ophthalmology of Ad-din Women Medical College Hospital, Dhaka, Bangladesh from June 2014 to June 2018. 175 patients of 189 eyes with significant PCO. Before laser capsulotomy all patients were assess by routine slit lamp examination, IOP measurement and posterior segment examination done for every patient for exclusion of Gross posterior segment pathology. Results: The study had female preponderance (58.86%). Most of the patients 165 were 40 to 80 years old (87.31%). The patients had pre laser visual acuity 6/9 to 6/18 (31.75%) 6/24 to <6/60 (68.25%). After laser capsulotomy functional visual acuity upto 6/8 were 169 (89.42%) and 6/24 to <6/60 were 20 (10.58%). The mean pre and post laser capsulotomy visual functional score were 54.45±36.44 and 94.16±50.36 respectively. Conclusion: Nd YAG laser capsulotomy is safe, non-invasive and effective procedure. Medicine Today 2021 Vol.33(2): 98-101

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