title: Infliximab after Boston Keratoprosthesis in Stevens-Johnson Syndrome: An Update.
abstract: OBJECTIVE
  To report our experience using intravenous infliximab for the treatment of tissue melt after Boston keratoprosthesis (B-KPro) types I and II in patients with autoimmune disease.
  
  
  METHODS
  Case series.
  
  
  RESULTS
  We identified four patients who were treated with intravenous infliximab in the context of tissue melt after B-KPro. Stevens-Johnson syndrome-associated corneal blindness was the primary surgical indication for B-KPro implantation in all patients. Two patients received a B-KPro type I and two patients received a B-KPro type II. The patients received intravenous infliximab for skin retraction around B-KPro type II, melting of the carrier graft or leak. Treatment resulted in a dramatic decrease in inflammation and, in some cases, arrest of the melting process. Cost and patient adherence were limiting factors to pursuing infliximab therapy. In addition, one patient developed infusion reactions.
  
  
  CONCLUSIONS
  Intravenous infliximab may be considered as globe- and sight-saving therapy for tissue melt after B-KPro.
authors.affiliation: a Department of Ophthalmology , Massachusetts Eye and Ear Infirmary and Harvard Medical School , Boston , Massachusetts , USA.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Robert
authors.affiliation: a Department of Ophthalmology , Massachusetts Eye and Ear Infirmary and Harvard Medical School , Boston , Massachusetts , USA.
authors.forename: Alja
authors.initials: A
authors.lastname: Črnej
authors.affiliation: a Department of Ophthalmology , Massachusetts Eye and Ear Infirmary and Harvard Medical School , Boston , Massachusetts , USA.
authors.forename: Lucy Q
authors.initials: LQ
authors.lastname: Shen
authors.affiliation: a Department of Ophthalmology , Massachusetts Eye and Ear Infirmary and Harvard Medical School , Boston , Massachusetts , USA.
authors.forename: George N
authors.initials: GN
authors.lastname: Papaliodis
authors.affiliation: a Department of Ophthalmology , Massachusetts Eye and Ear Infirmary and Harvard Medical School , Boston , Massachusetts , USA.
authors.forename: Reza
authors.initials: R
authors.lastname: Dana
authors.affiliation: b Massachusetts Eye Research & Surgery Institute , Waltham , Massachusetts , USA.
authors.forename: C Stephen
authors.initials: CS
authors.lastname: Foster
authors.affiliation: a Department of Ophthalmology , Massachusetts Eye and Ear Infirmary and Harvard Medical School , Boston , Massachusetts , USA.
authors.forename: James
authors.initials: J
authors.lastname: Chodosh
authors.affiliation: a Department of Ophthalmology , Massachusetts Eye and Ear Infirmary and Harvard Medical School , Boston , Massachusetts , USA.
authors.forename: Claes H
authors.initials: CH
authors.lastname: Dohlman
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001187:Artificial Organs; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D013262:Stevens-Johnson Syndrome / Q000503:physiopathology / Q000601:surgery*; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents; D000069285:Infliximab
keywords: Boston keratoprosthesis; Stevens–Johnson syndrome; corneal melting; infliximab; keratolysis