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Keratoprosthesis in dry eye disease

Bilateral corneal blindness with severe dry eye disease (DED), total limbal stem cell deficiency with underlying corneal stromal scarring and vascularization, combined with adnexal complications secondary to chronic cicatrizing conjunctivitis is a highly complex situation to treat. In such eyes, pro...

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Autores principales: Sharma, Supriya, Donthineni, Pragnya Rao, Iyer, Geetha, Chodosh, James, de la Paz, Maria Fideliz, Maskati, Quresh, Srinivasan, Bhaskar, Agarwal, Shweta, Basu, Sayan, Shanbhag, Swapna S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10276669/
https://www.ncbi.nlm.nih.gov/pubmed/37026247
http://dx.doi.org/10.4103/IJO.IJO_2817_22
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author Sharma, Supriya
Donthineni, Pragnya Rao
Iyer, Geetha
Chodosh, James
de la Paz, Maria Fideliz
Maskati, Quresh
Srinivasan, Bhaskar
Agarwal, Shweta
Basu, Sayan
Shanbhag, Swapna S
author_facet Sharma, Supriya
Donthineni, Pragnya Rao
Iyer, Geetha
Chodosh, James
de la Paz, Maria Fideliz
Maskati, Quresh
Srinivasan, Bhaskar
Agarwal, Shweta
Basu, Sayan
Shanbhag, Swapna S
author_sort Sharma, Supriya
collection PubMed
description Bilateral corneal blindness with severe dry eye disease (DED), total limbal stem cell deficiency with underlying corneal stromal scarring and vascularization, combined with adnexal complications secondary to chronic cicatrizing conjunctivitis is a highly complex situation to treat. In such eyes, procedures such as penetrating keratoplasty alone or combined with limbal stem cell transplantation are doomed to fail. In these eyes, keratoprosthesis (Kpro) or an artificial cornea is the most viable option, eliminating corneal blindness even in eyes with autoimmune disorders such as Stevens–Johnson syndrome, ocular mucous membrane pemphigoid, Sjogren’s syndrome, and nonautoimmune disorders such as chemical/thermal ocular burns, all of which are complex pathologies. Performing a Kpro in these eyes also eliminates the need for systemic immunosuppression and may provide relatively early visual recovery. In such eyes, the donor cornea around the central cylinder of the Kpro needs to be covered with a second layer of protection to avoid desiccation and progressive stromal melt of the underlying cornea, which is a common complication in eyes with severe DED. In this review, we will focus on Kpro designs that have been developed to survive in eyes with the hostile environment of severe DED. Their outcomes in such eyes will be discussed.
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spelling pubmed-102766692023-06-18 Keratoprosthesis in dry eye disease Sharma, Supriya Donthineni, Pragnya Rao Iyer, Geetha Chodosh, James de la Paz, Maria Fideliz Maskati, Quresh Srinivasan, Bhaskar Agarwal, Shweta Basu, Sayan Shanbhag, Swapna S Indian J Ophthalmol Review Article - Clinical Bilateral corneal blindness with severe dry eye disease (DED), total limbal stem cell deficiency with underlying corneal stromal scarring and vascularization, combined with adnexal complications secondary to chronic cicatrizing conjunctivitis is a highly complex situation to treat. In such eyes, procedures such as penetrating keratoplasty alone or combined with limbal stem cell transplantation are doomed to fail. In these eyes, keratoprosthesis (Kpro) or an artificial cornea is the most viable option, eliminating corneal blindness even in eyes with autoimmune disorders such as Stevens–Johnson syndrome, ocular mucous membrane pemphigoid, Sjogren’s syndrome, and nonautoimmune disorders such as chemical/thermal ocular burns, all of which are complex pathologies. Performing a Kpro in these eyes also eliminates the need for systemic immunosuppression and may provide relatively early visual recovery. In such eyes, the donor cornea around the central cylinder of the Kpro needs to be covered with a second layer of protection to avoid desiccation and progressive stromal melt of the underlying cornea, which is a common complication in eyes with severe DED. In this review, we will focus on Kpro designs that have been developed to survive in eyes with the hostile environment of severe DED. Their outcomes in such eyes will be discussed. Wolters Kluwer - Medknow 2023-04 2023-04-05 /pmc/articles/PMC10276669/ /pubmed/37026247 http://dx.doi.org/10.4103/IJO.IJO_2817_22 Text en Copyright: © 2023 Indian Journal of Ophthalmology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Review Article - Clinical
Sharma, Supriya
Donthineni, Pragnya Rao
Iyer, Geetha
Chodosh, James
de la Paz, Maria Fideliz
Maskati, Quresh
Srinivasan, Bhaskar
Agarwal, Shweta
Basu, Sayan
Shanbhag, Swapna S
Keratoprosthesis in dry eye disease
title Keratoprosthesis in dry eye disease
title_full Keratoprosthesis in dry eye disease
title_fullStr Keratoprosthesis in dry eye disease
title_full_unstemmed Keratoprosthesis in dry eye disease
title_short Keratoprosthesis in dry eye disease
title_sort keratoprosthesis in dry eye disease
topic Review Article - Clinical
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10276669/
https://www.ncbi.nlm.nih.gov/pubmed/37026247
http://dx.doi.org/10.4103/IJO.IJO_2817_22
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