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Impact of keratoprosthesis implantation on retinal and visual pathway function assessed by electrophysiological testing

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Abstract

Purpose

To investigate the impact of Boston Type I Keratoprosthesis (BI-Kpro) implantation on retinal and visual pathway function, respectively, assessed by full-field electroretinography (ERG) and visually evoked potentials (VEPs).

Methods

This is a prospective interventional longitudinal study, and patients with BI-Kpro implantation were assessed preoperatively and at 3 and 12 months after surgery. ERG, flash, and pattern-reversal VEPs (15’ and 60’ checks) along with visual acuity (VA) were performed.

Results

A total of 13 patients (24 to 88 years of age) were included. Mean baseline VA (logMAR) improved from 2.30 to 1.04 at 3 months and to 1.00 at 12 months. Flash VEPs were normal in 6 (46%) patients and in 10 (77%) patients at the 12-month follow-up. PVEP was non-detectable in all patients preoperatively for both check sizes. For 15’ check size, 6 (46%) patients showed responses after 3 and 12 months except for 1 patient with normal responses at 12 months with the remaining non-detectable. For 60’ checks, 11 (85%) patients had responses 3 months after surgery with only 9 (70%) showing responses at 12 months. Abnormal full-field ERGs were found in all patients preoperatively. Amplitude improvement was found in 10 (77%) patients from baseline to 3 months and in 8 (62%) patients from the 3- to the 12-month follow-up.

Conclusions

In this small cohort of patients with BI-Kpro implantation, a remarkable improvement on visual function quantitatively assessed by electrophysiological testing was found in the majority of cases. Visual electrophysiological testing can contribute to objectively assess functional outcomes in this population.

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Funding

The study was supported by a grant from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) – Ministério da Educação – Brasil (PNPD 2374/2011) to LAO and Finance Code 001 to LDS.

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Authors and Affiliations

  1. Departamento de Oftalmologia E Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, Rua Botucatu, 806, SP, 04023-062, São Paulo, Brazil

    Luzia Diegues Silva, Adriana Berezovsky, Solange Rios Salomão, Nívea Nunes Ferraz, Carina Verna, Tarciana de Souza Soares & Lauro Augusto de Oliveira

Authors
  1. Luzia Diegues Silva
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  2. Adriana Berezovsky
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  3. Solange Rios Salomão
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  4. Nívea Nunes Ferraz
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  5. Carina Verna
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  6. Tarciana de Souza Soares
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  7. Lauro Augusto de Oliveira
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Corresponding author

Correspondence to Lauro Augusto de Oliveira.

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Ethical approval

The retrospective chart review involving human participants was in accordance with the ethical standards of the Committee on Ethics in Research of Federal University of São Paulo (CEP 0397/2015) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Silva, L.D., Berezovsky, A., Salomão, S.R. et al. Impact of keratoprosthesis implantation on retinal and visual pathway function assessed by electrophysiological testing. Graefes Arch Clin Exp Ophthalmol 261, 1627–1637 (2023). https://doi.org/10.1007/s00417-022-05961-7

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  • DOI: https://doi.org/10.1007/s00417-022-05961-7

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