title: Use of intraocular video endoscopic examination in the preoperative evaluation of keratoprosthesis surgery to assess visual potential.
abstract: OBJECTIVE
  To determine the clinical utility of intraocular videoendoscopy examination for the evaluation of the retina and optic nerve in patients being considered for a Boston type I keratoprosthesis (KPro).
  
  
  METHODS
  Interventional case series study.
  
  
  METHODS
  Ten patients with a history of corneal blindness caused by failed penetrating keratoplasty (PK) and inability to accurately assess visual potential were included in this study. Ophthalmologic examination, B-scan ultrasonography, and pars plana videoendoscopy were carried out to assess the retina and optic nerve before KPro.
  
  
  RESULTS
  Posterior segment examination was successfully used to evaluate the retina and optic nerve of all patients with opaque corneas. Out of 10 patients that underwent endoscopic examination, 3 (30%) were considered to be adequate candidates for KPro surgery and 7 (70%) were not. This was based on visualized retinal disease and/or optic nerve pathology. Of the 3 patients that underwent KPro surgery, all of them had a significant improvement of vision, including counting fingers to 20/100, hand motion to 20/5, and light perception to 20/80, as suggested by the endoscopy preoperative examination. No complications of the endoscopy procedure were observed.
  
  
  CONCLUSIONS
  This report demonstrates the successful use of intraocular videoendoscopy to rule out threats to a good visual outcome for patients being considered as candidates for KPro. Direct visualization of the posterior segment can be part of the preoperative algorithm in the decision process of performing a KPro surgery in patients when visual potential is questionable.
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Ocular Surface Center of Excellence, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Charles C
authors.initials: CC
authors.lastname: Farias
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Ocular Surface Center of Excellence, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Hilal E
authors.initials: HE
authors.lastname: Ozturk
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Albini
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Audina M
authors.initials: AM
authors.lastname: Berrocal
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Ocular Surface Center of Excellence, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Amescua
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Ocular Surface Center of Excellence, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Carolina
authors.initials: C
authors.lastname: Betancurt
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Parel
authors.affiliation: Department of Ophthalmology, Cornea Service, Centro Oftalmologico de Valencia, Valencia, Venezuela.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Oliveros
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Ocular Surface Center of Excellence, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Allister
authors.initials: A
authors.lastname: Gibbons
authors.affiliation: Department of Ophthalmology, Cornea Service, Centro Oftalmologico de Valencia, Valencia, Venezuela.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Vargas
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Ocular Surface Center of Excellence, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida. Electronic address: vperez4@med.miami.edu.
authors.forename: Victor L
authors.initials: VL
authors.lastname: Perez
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D001187:Artificial Organs; D003315:Cornea; D003318:Corneal Opacity / Q000601:surgery; D003657:Decision Making; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000473:pathology / Q000503:physiopathology; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000503:physiopathology; D018579:Patient Selection; D057234:Preoperative Period; D019919:Prosthesis Implantation; D012164:Retinal Diseases / Q000175:diagnosis* / Q000503:physiopathology; D014741:Video Recording; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult