Cornea - ARVO

ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - CorneaPurpose: 1) To evaluate the association between phakic status andthe risk of postoperative cystoid macular edema (CME) afterimplantation of Boston Keratoprosthesis Type I (Kpro). 2) Toevaluate the association between iris-backplate touch (IBPT) onanterior segment optical coherence tomography (ASOCT) and therisk of postoperative CME after Kpro.Methods: Retrospective non-interventional chart review. All patientswho underwent Kpro type I implantation at the Illinois Eye and EarInfirmary from 2007-2012 were reviewed. Patients were included inthe study if they had at least one postoperative macular OCT and onepostoperative ASOCT. Patients were excluded for poor qualityimages and aniridia. For all patients who met inclusion criteria, datawere obtained including phakic status, pre-op and post-op visualacuity, time to final follow up, presence of CME on macular OCTand presence of IBPT on ASOCT. Two-tailed Fisher’s exact test wasthen performed to evaluate the statistical significance of phakic statusand IBPT on postoperative CME.Results: One hundred and three Kpro were implanted into 95 eyes of94 patients over a 5 year period. Fifty-eight eyes met inclusioncriteria. Seven eyes were excluded for poor image quality andaniridia. Of the remaining 51 eyes, 21 (41.1%) had CME onpostoperative macular OCT and 9 (17.6%) were pseudophakic. OnFisher’s Exact Test there was a statistically significant positivecorrelation between implantation of pseudophakic-typekeratoprosthesis and presence of postoperative CME (p = 0.023). Onreview of ASOCT, 23 (45.1%) had evidence of IBPT. There was nosignificant correlation found between IBPT and postoperative CMEon Fisher’s exact test (p = 0.167).Conclusions: CME is a frequent postoperative complication afterKpro implantation and can contribute to poor visual acuity outcomes.Patients with pseudophakic Kpros may be at higher risk forpostoperative CME. Although IBPT may be a source of chronicinflammation in these patients, its presence on ASOCT is not a riskfactor for postoperative CME.Commercial Relationships: Kaitlyn M. Wallace, None; Joshua H.Hou, None; Randee C. Miller, None; Clement C. Chow, None;Jose De la Cruz, alcon (C), amo (C); Felix Y. Chau, None; MariaS. Cortina, NoneProgram Number: 3463 Poster Board Number: D0090Presentation Time: 11:00 AM - 12:45 PMIn vivo evaluation of microbial infection on surfacefunctionalized titanium as artificial cornea candidate materialXiao-Wei Tan 1 , Rajamani Lakshminarayanan 1 , Gwendoline Goh 1 ,Melina Setiawan 1 , Shouping Liu 1 , Roger W. Beuerman 1, 2 , Donald T.Tan 3, 4 , Jodhbir S. Mehta 1, 3 . 1 Singapore Eye Research Institute,Singapore, Singapore; 2 Yong Loo Lin School of Medicine, NationalUniversity of Singapore, Singapore, Singapore; 3 Singapore NationalEye Centre, Singapore, Singapore; 4 Department of Clinical Sciences,Duke-NUS Graduate Medical School, Singapore, Singapore.Purpose: Artificial keratoprosthesis skirts are prone tomicrobiological infection after implantation. Previous studies haveshown that coating titanium surface with antimicrobial peptide(AMP), human beta-defensin analogue SESB2V, could improve thebactericidal effect of the titanium alloy in an in vitro environment.Here we aimed to test the bactericidal effect of the functionalizedtitanium oxide (TiO2) with a rabbit cornea infection model.Methods: SESB2V AMP was bound onto the surface of titaniumoxide via crosslinking with polydopamine. A corneal stroma pocketwas created by a femtosecond laser assisted LASIK surgery. TiO2discs were inserted into the pocket through a small corneal incision.After 1 week of wound healing, 50 ul S.aureus (1X103 CFU/ml)were injected into the pocket right above the TiO2 inserts. Theimplanted corneas were compared with normal and sham-operatedcorneas through slit lamp observation and anterior segment opticalcoherence tomography (AS-OCT). After 2 days of infection, rabbitcornea tissue was collected for haematoxylin and eosin (H&E)staining. Inflammatory response was also evaluated by staining withCD11b and MMP9 antibodiesResults: There were less incidence of corneal infection and lessextent of infection on rabbit corneas with SESB2V coated implantscompared to those corneas with non-coated implant. Histologicalanalysis also revealed that less inflammatory cells were found in thecornea pocket tissue with the AMP coated TiO2 discs compared tothose with non-coated TiO2 discs.Conclusions: SESB2V AMP significantly improved the bactericidaleffect of TiO2 discs in vivo, which is a potential candidatebiomaterial for artificial cornea skirt. This would further expand theusage of TiO2 in the development of keratoprosthesis device.Commercial Relationships: Xiao-Wei Tan, None; RajamaniLakshminarayanan, None; Gwendoline Goh, None; MelinaSetiawan, None; Shouping Liu, None; Roger W. Beuerman,Allergan (F), SERI (P), Santen (R); Donald T. Tan, NetworkMedical Products (P), Carl Zeiss Meditec (F), Alcon Labs (F),Bausch & Lomb (F), Allergan (F), Santen (F); Jodhbir S. Mehta,NoneSupport: SHF/FG488S/2010Program Number: 3464 Poster Board Number: D0091Presentation Time: 11:00 AM - 12:45 PMBandage CL fitting characteristics and complications in patientswith Boston Type I keratoprosthesis surgeryEllen Shorter, Charlotte E. Joslin, Timothy T. McMahon, Jose De laCruz, Maria S. Cortina. University of Illinois at Chicago, Chicago,IL.Purpose: To describe bandage contact lens fitting characteristics andcomplications in patients that have undergone Boston Type Ikeratoprosthesis surgery at the University of Illinois at Chicago(UIC). Proper bandage lens fit is critical to lens retention and isnecessary to protect the ocular surface from complications related tocorneal desiccation.Methods: Medical records data was abstracted and analyzed amongpatients who underwent Boston Type I keratoprosthesis surgery atUIC between January 1, 2007 and June 1, 2012.Results: 76 eyes of 71 patients were identified who underwentsurgery at UIC with a minimum of 6 months of follow-up. Presurgicalindications included non-inflammatory (38 eyes), limbalstem cell deficiency (LSCD) (20 eyes), chemical/thermal burn (14eyes) and autoimmune disease (4 eyes). Forty-three percent achievedvisual acuity of 20/200 or better compared to 3% before surgery.Bandage lens loss occurred between visits in 38% of patients anddeposits were noted in 20%. Lens loss was more common in theLSCD and chemical burn group while lens deposits were mostcommon in the autoimmune group.The final bandage lens incorporated a power change in 38% while30% remained in the same fitting parameters as the initial postsurgicallens. Sagittal depth was increased by decreasing the basecurve or increasing the diameter in 37%. Frequent replacementsilicone hydrogel lenses were used to re-fit 22% of patients. Hybridcontact lenses were fit in 7% of patients due to frequent lens loss orvisually significant deposits despite refitting.Of the eyes with corneal melt requiring repeat keratoprosthesis orkeratoprosthesis removal, 62% had problems with bandage lens loss.Corneal melt occurred in 8% of the non-inflammatory group, 35% inthe LSCD group, 21% in the chemical and thermal burn group and inno eyes in the autoimmune group. At last follow-up, 91% retained a©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the ARVO Office at arvo@arvo.org.