Bilateral Boston keratoprosthesis type 1 in a case of severe Mooren's ulcer.

European Journal of Ophthalmology
Marta Jerez-PeñaRafael I Barraquer

Abstract

Mooren's ulcer is a painful, inflammatory chronic keratitis that affects corneal periphery, progressing centripetally, ultimately ending in perforation. The first line of treatment includes systemic immunomodulators, with surgery being the last option. We present a case of bilateral Boston keratoprosthesis implantation for severe Mooren's ulcer that responded differently in each eye. A 32-year-old male with corneal opacification, anterior staphylomas, vision of hand movement, was started on systemic immunosuppression with cyclosporine. After two failed penetrating keratoplasties in each eye, high intraocular pressure despite diode cyclophotocoagulation, and cystic macular edema, we performed Boston keratoprosthesis type 1 in both eyes. The right eye responded initially well, with a best-corrected visual acuity of 20/80 and normal intraocular pressure. The left eye presented high intraocular pressure, which required cyclophotocoagulation, ultimately resulting in hypotony. Boston keratoprosthesis was performed but had peripheral corneal necrosis that progressed despite amniotic membrane transplantation and aggressive intensive treatment with medroxyprogesterone, autologous platelet-rich-in-growth-factors eye drops, and oral doxyc...Continue Reading

References

Oct 13, 2006·The British Journal of Ophthalmology·Muthaiah SrinivasanEmmett T Cunningham
Mar 23, 2011·International Ophthalmology·Sayan BasuVirender S Sangwan
Nov 11, 2015·The British Journal of Ophthalmology·Ikeda LalJayesh Vazirani
Feb 22, 2016·Archivos de la Sociedad Española de Oftalmología·F VilaplanaJ Barraquer
Jul 28, 2016·The British Journal of Ophthalmology·Damien GuindoletEric E Gabison
Jul 26, 2017·Journal of Ophthalmology·Lixia YangHan Zhang

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Citations

Jun 20, 2020·European Journal of Ophthalmology·Dominique Geoffrion, Mona Harissi-Dagher
Mar 4, 2021·Survey of Ophthalmology·Yogita GuptaRadhika Tandon

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