title: Periprosthetic Tissue Loss in Patients With Idiopathic Vitreous Inflammation After the Boston Keratoprosthesis.
abstract: OBJECTIVE
  Idiopathic vitritis is a poorly understood complication after Boston keratoprosthesis surgery with unclear etiology. We sought to determine whether an association exists between periprosthetic corneal tissue loss and the development of idiopathic vitritis in keratoprosthesis recipients.
  
  
  METHODS
  Thirteen Boston type I keratoprosthesis recipient eyes with a history of idiopathic vitritis and 34 type I keratoprosthesis recipient eyes with no history of idiopathic vitritis underwent anterior segment optical coherence tomography (AS-OCT) at a median time postoperatively of 2.4 years versus 1.9 years (range, 0.5-14.2 vs. 0.1-13.6 years), respectively. Areas of corneal graft tissue loss ("gaps") around the keratoprosthesis stem were identified and analyzed by 2 masked observers. The difference in the presence, number, and size of gaps was compared between cases and controls.
  
  
  RESULTS
  A periprosthetic gap was identified more commonly in idiopathic vitritis cases than in controls on AS-OCT (11/13, 86% vs. 11/34, 33.3%, P < 0.001). The number of gaps between cases and controls was also significantly different (2.6 ± 1.6 vs. 0.5 ± 0.8, P < 0.001), but not the estimated gap area (0.056 ± 0.049 mm² vs. 0.039 ± 0.025 mm², P = 0.22).
  
  
  CONCLUSIONS
  A significantly higher proportion of keratoprosthesis recipient eyes with idiopathic vitritis had corneal tissue loss around the keratoprosthesis stem than did controls. Tissue loss could serve as an entry point for debris or bacterial components, triggering idiopathic vitritis. Our study underscores the utility of AS-OCT imaging in the postoperative management of keratoprosthesis patients.
authors.affiliation: Massachusetts Eye & Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Grassi
authors.forename: Andrea
authors.initials: A
authors.lastname: Cruzat
authors.forename: Elise V
authors.initials: EV
authors.lastname: Taniguchi
authors.forename: Alja
authors.initials: A
authors.lastname: Crnej
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Colby
authors.forename: Claes H
authors.initials: CH
authors.lastname: Dohlman
authors.forename: James
authors.initials: J
authors.lastname: Chodosh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021522:Bioartificial Organs / Q000009:adverse effects*; D003315:Cornea / Q000473:pathology*; D016039:Corneal Transplantation; D005128:Eye Diseases / Q000209:etiology*; D005260:Female; D006084:Graft Rejection / Q000473:pathology*; D006801:Humans; D007249:Inflammation / Q000209:etiology; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014822:Vitreous Body / Q000473:pathology*