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INSTITUTO DE OJOS Dr. HUGO DANIEL NANO Buenos Aires, Argentina

Six-Month Follow up of 2 Keratoprosthesis Types in patients with Ocular Pemphigoid Authors : Hugo Daniel Nano MD, Julian Schvartzberg MD, Pilar Maria Nano MD, Hugo Diego Nano MD, Sergio Muzzin MD . INSTITUTO DE OJOS Dr. HUGO DANIEL NANO Buenos Aires, Argentina.

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INSTITUTO DE OJOS Dr. HUGO DANIEL NANO Buenos Aires, Argentina

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  1. Six-MonthFollow up of 2 KeratoprosthesisTypes in patientswith Ocular PemphigoidAuthors: Hugo Daniel Nano MD, JulianSchvartzberg MD, Pilar Maria Nano MD, Hugo Diego Nano MD, Sergio Muzzin MD INSTITUTO DE OJOS Dr. HUGO DANIEL NANO Buenos Aires, Argentina No financial disclosures to discuss

  2. Purpose: • The purpose of this presentation is to evaluate safety, visual gain and stability of the Boston type I and II keratoprosthesis through the analysis of 2 patients diagnosed with Ocular Pemphigoid which underwent surgery with either type I or type II Boston Keratoprosthesis.

  3. Keratoprosthesis Type I and Type II Type I Type II

  4. Methods: • 2 eyes of 2 patients, both female, with an average age of 69 years, diagnosed with Ocular Cicatricial Pemphigoid . The preoperative clinical examination included uncorrected visual acuity (UCVA) with Snellen Charts, and cerographic examination of the retina. The same surgeon performed both surgeries, one patient received a type I Boston Keratoprosthesis and the other a type II Boston Keratoprosthesis, following the manufacturer indications.

  5. PreoperativePictures: Patient with ocular pemphigoid

  6. Results: • In the preoperative stage, both the uncorrected visual acuity and binocular visual acuity was hand motion for both cases. The postoperative data at the first month follow-up showed an improvement in at least 1 line of uncorrected visual acuity in both patients; the patient who received the type I keratoprosthesis improved from hand motion to 0,06/10 UCVA, and the patient who received the type II improved from hand motion to 1 meter counting fingers UCVA. After 3 months follow up both patients managed to maintain the same visual acuity, and after 6 months follow-up both patients gained lines of UCVA. The case with type I improved from 0,06/10 to 1/10 UCVA and the case with type II improved from counting fingers to 0,06/10 UCVA.

  7. Conclusions: • Although more patients and longer follow-up is needed, we can conclude that in terms of visual acuity, both patients showed a significant improvement; therefore in patients with severe corneal pathology such as ocular pemphigoid or patients with multiple graft failure, the Boston Keratoprosthesis type I and type II shows to be an efficient and considerable alternative, however in patients with ocular pemphigoid the type II keratoprosthesis showed more stability than type I in controlling and improving visual acuity. Type I postoperative Type II postoperative

  8. Bibliography: • Khan BF, Harissi-Dagher M, Dohlman CH. Keratoprosthesis- Albert DM, Miller JW, eds, Azar DT, Blodi BA, assoc. eds In: Albert and Jakobiec´s Principles and Practice in Ophthalmology, 3rd Edition. • Harissi-Dagher M, Khan BF, Dohlman CH. The Boston Keratoprosthesis. In: Corneal Transplantation. Rasik B Vajpayee, ed, Namrata Sharma, Geoffrey C Tabin and Hugh R Taylor, co-editors. Vajaypee Brothers Medical Publishers. New Delhi, in press. • Khan BF, Harissi-Dagher M, Dohlman CH. Advances in Boston Keratoprosthesis: Enhancing Retention and Prevention of Infection and Inflammation. Int Ophtalmol Clin 2007; 47:61-71 • John T: Artificial Cornea: Surgical use of Boston Keratoprosthesis. Ann of Ophtalmol 2008; 40: 2-7.

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