1. Sergio Kwitko, Andressa P. Stolz, Melissa Dal Pizzol, Diane Marinho, Samuel Rymer Ophthalmology Department - Hospital de Clínicas de Porto Alegre Federal University of Rio Grande do Sul - Porto Alegre - Brazil The authors have no financial interest in the subject matter of this poster Experience with Dohlman-Doane keratoprosthesis: case reports

2. Purpose To describe 14 eyes of 13 patients who had received Dohlman-Doane type 1 Keratoprostesis (Kpro) with a mean follow-up of 25.5 months (range, 1 to 49 months).

3. Methods A retrospective, noncomparative interventional case series. Previous corneal disease was: – bilateral alkaline burn (5 eyes) – multiple graft failure (6 eyes) – Stevens-Johnson Syndrome (2 eyes) – thermal injury (1 eye) Best corrected spectacle visual acuity (BSCVA) was hand motions or worse in all eyes. Glaucoma was present in 3 eyes preoperatively and received Ahmed valve implantation. Post operative care is the same of conventional penetrating keratoplasty, added with continuous therapeutic contact lens, medroxiprogesterone and antibiotic drops.

4. Results 64% of eyes achieved BSCVA of ≥ 20/100 and 42.8% ≥ 20/40 (see table 1). In these eyes, post operative visual field was stable, in 30-50º. Complications: – 6 eyes: posterior capsule opacification treated with YAG laser capsulotomy; – 5 eyes: corneal necrosis (4 treated with donor cornea bottom exchange); – 3 eyes: retroprosthetic membrane treated with tPA injection; – 2 eyes: vitreitis treated with posterior vitrectomy; – 1 eye: fungal keratitis (ended with post traumatic inoperable retinal detachment); – 1 eye: fusarium endophthalmitis, treated with corneal transplant, anterior vitrectomy, Kpro and intraocular lens explantation, as well as specific intravitreal and endovenous treatment. – 1 eye: eviscerated after irreversible phthisis bulbi occurrence.

5. Figure 1. Patient 2: Pre(A) and 15 months post K-Pro(B) A B

6. Table 1: Cases that received Keratoprosthesis implantation

7. Conclusion Dohlman Kpro seems to be a good option for cases in witch penetrating keratoplasty contraindications. Advantages: does not need systemic immunossupression good visual outcome. Best results were achieved in non-immune diseases.

8. References 1.Ma JJ, Graney JM, Dohlman CH. Repeat penetrating keratoplasty versus the Boston keratoprosthesis in graft failure. Int Ophthalmol Clin 2005;45:49. 2.Aquavella JV, Qian Y, McCormick GJ, Palakuru JR. Keratoprosthesis: the Dohlman-Doane device. Am J Ophthalmol 2005;140:1032. 3.Doane MG, Dohlman CH, Bearse G. Fabrication of a keratoprosthesis. Cornea 1996;15:179. 4.Zerbe BL, Belin MW, Ciolino JB. Results from the multicenter Boston Type 1 Keratoprosthesis Study. Ophthalmology 2006;113:1779. 5.Bradley JC, Hernandez EG, Schwab IR, Mannis MJ. Boston type 1 keratoprosthesis: the university of california davis experience. Cornea 2009;28:321. 6.Sayegh RR, Ang LP, Foster CS, Dohlman CH. The Boston keratoprosthesis in Stevens- Johnson syndrome. Am J Ophthalmol 2008; 145:438. 7.Barnes SD, Dohlman CH, Durand ML. Fungal colonization and infection in Boston keratoprosthesis. Cornea 2007;26:9. 8.Aldave AJ, Kamal KM, Vo RC, Yu F. The Boston type I keratoprosthesis: improving outcomes and expanding indications. Ophthalmology 2009; 116:640.