title: Stromal melting associated with a cosmetic contact lens over a Boston keratoprosthesis: treatment with a conjunctival flap.
abstract: OBJECTIVE
  The aim was to discuss the use of a conjunctival flap for treatment of keratolysis of a keratoprosthesis (Kpro) donor graft in a patient fitted with a cosmetic contact lens.
  
  
  METHODS
  Keratolysis developed in the donor graft of a Boston Kpro; this was associated with the use of a cosmetic contact lens. A conjunctival flap was used to stabilize the graft. The literature is reviewed for similar cases, and the rationale for the intervention is described and discussed.
  
  
  RESULTS
  Reinforcement of the graft with a conjunctival flap resulted in an arrest in stromal melting and stabilization of visual acuity.
  
  
  CONCLUSIONS
  Low Dk opaque contact lenses may be a risk factor for keratolysis after Kpro. A conjunctival flap technique can provide stabilization of keratolysis with arrest of corneal melting and merits further study.
authors.affiliation: Department of Ophthalmology, University of Oklahoma, Oklahoma City, OK, USA.
authors.forename: Ore-ofe O
authors.initials: OO
authors.lastname: Adesina
authors.forename: Jean A
authors.initials: JA
authors.lastname: Vickery
authors.forename: Carri L
authors.initials: CL
authors.lastname: Ferguson
authors.forename: Donald U
authors.initials: DU
authors.lastname: Stone
mesh_terms: D000328:Adult; D003228:Conjunctiva / Q000637:transplantation*; D003261:Contact Lenses / Q000009:adverse effects*; D003320:Corneal Ulcer / Q000601:surgery*; D005260:Female; D006801:Humans; D011183:Postoperative Complications; D019736:Prostheses and Implants; D013524:Surgical Flaps; D016896:Treatment Outcome