title: ULTRA-WIDEFIELD IMAGING OF POSTERIOR SEGMENT PATHOLOGY IN THE SETTING OF THE BOSTON KERATOPROSTHESIS.
abstract: OBJECTIVE
  To evaluate the ability to visualize and document posterior segment pathology through the Boston keratoprosthesis (KPro) using the Optos P200Tx ultra-widefield (UWF) scanning laser ophthalmoscope.
  
  
  METHODS
  A retrospective chart review was conducted of patients who underwent Boston Type I keratoprosthesis implantation and who subsequently were imaged with an UWF system. Ultra-widefield images were reviewed to evaluate for vitreoretinal pathology and were compared with the clinical examination.
  
  
  RESULTS
  In this series of 10 patients (10 eyes), 100% of vitreoretinal pathology found on clinical examination was detectable using the Optos system. In 4 cases (40%), UWF imaging provided superior detection of pathology compared with the clinical examination by imaging through retroprosthetic membranes (3 cases) and by detection of a retinal detachment (one case). In 1 case (10%), B-scan ultrasonography was needed to characterize vitreoretinal pathology that could not be definitively distinguished on UWF imaging and was difficult to detect on clinical examination. Ultra-widefield imaging detected the following vitreoretinal pathologies in KPro eyes: retinal hemorrhage, epiretinal membrane, retinal detachment, proliferative diabetic retinopathy, and choroidal folds.
  
  
  CONCLUSIONS
  Ultra-widefield imaging provides a high-resolution view of the posterior pole and periphery despite the limitations of imaging through the narrow optic of Boston Type I keratoprosthesis, and it may improve visualization through retroprosthetic membranes. Detection and documentation of vitreoretinal complications in the setting of a permanent keratoprosthesis may be enhanced using UWF imaging.
authors.affiliation: *Department of Ophthalmology, Weill Cornell Medical College, New York, NY; and †Retina Division, Stein Eye Institute/UCLA Medical Center, Los Angeles, CA.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Kornberg
authors.forename: Nicolas A
authors.initials: NA
authors.lastname: Yannuzzi
authors.forename: Michael A
authors.initials: MA
authors.lastname: Klufas
authors.forename: Donald J
authors.initials: DJ
authors.lastname: DʼAmico
authors.forename: Anton
authors.initials: A
authors.lastname: Orlin
authors.forename: Szilárd
authors.initials: S
authors.lastname: Kiss
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001187:Artificial Organs; D001705:Bioprosthesis; D003315:Cornea; D003316:Corneal Diseases / Q000601:surgery*; D005128:Eye Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057972:Posterior Eye Segment / Q000000981:diagnostic imaging* / Q000473:pathology; D019736:Prostheses and Implants; D012189:Retrospective Studies