Use of Preoperative Imaging for Surgical Planning in Patients Undergoing Boston Keratoprosthesis Type 1

摘要

Purpose: To describe the use of ultrasound biomicroscopy (UBM) preoperatively for the purpose of surgical planning in patients undergoing Boston keratoprosthesis (KPro) type 1. Methods: Retrospective case series. Results: Records of 3 patients who underwent UBM before implantation of a Boston keratoprosthesis type 1 were analyzed. Anatomical constraints seen with UBM analysis included depth of anterior chamber, thickness of existing cornea, pre-existing glaucoma tube shunts or intraocular lenses, and scarring of anterior chamber angle. Surgical planning was devised based on UBM imaging and included the following relevant procedures: synechiolysis, iris sphincterotomy, lensectomy, or explantation of a pre-existing posterior chamber lens. In addition, in patients with coexisting glaucoma, implantation of a de novo tube shunt at the time of implantation of the KPro was considered; based on anterior chamber anatomy, a tube shunt, when necessary, was placed either in the anterior chamber or through the pars plana. Conclusions: The use of UBM preoperatively was found to be very useful for proper surgical planning in patients undergoing Boston KPro type 1 implantation.