Keratoprosthesis in autoimmune disease.
OBJECTIVE
To describe the clinical features and course of 2 patients with autoimmune diseases and their experience with the Boston keratoprosthesis. To draw on general medical literature to try to better understand recurrent complications.


METHODS
Retrospective review of 2 patients treated with Boston keratoprostheses. The clinical histories, examinations, and other diagnostics were reviewed. A literature review was performed.


RESULTS
The first patient presented with end-stage ocular disease secondary to toxic epidermal necrolysis (TENS). The second patient presented with end-stage ocular disease secondary to mucous membrane pemphigoid (MMP). Both patients underwent treatment with the Boston keratoprosthesis. Both patients suffered numerous corneal melts requiring multiple repeat implantations.


CONCLUSIONS
Patients with corneal blindness secondary to autoimmune disease often fare poorly with available surgical treatments. Study of existing literature on prosthetic device complications in autoimmune diseases may help uncover common mechanisms of tissue destruction to establish perioperative immunomodulatory regimens targeted to specific underlying diseases.
Ciralsky
Jessica
J
Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA.
Papaliodis
George N
GN
Foster
C Stephen
CS
Dohlman
Claes H
CH
Chodosh
James
J
D000328:Adult; D000528:Alternaria / Q000187:drug effects; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000150:complications*; D001766:Blindness / Q000209:etiology / Q000601:surgery*; D003316:Corneal Diseases / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D009181:Mycoses / Q000188:drug therapy; D010390:Pemphigoid, Benign Mucous Membrane / Q000150:complications*; D011239:Prednisolone / Q000627:therapeutic use; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D013262:Stevens-Johnson Syndrome / Q000150:complications*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D011239:Prednisolone; D000069285:Infliximab; D009173:Mycophenolic Acid