Keratoprosthesis in autoimmune disease

Area of Science:

• Ophthalmology
• Autoimmune Diseases
• Prosthetic Devices

Background:

• Autoimmune diseases can lead to end-stage ocular disease and corneal blindness.
• The Boston keratoprosthesis is a surgical option for severe corneal blindness.

Observation:

• Two patients with autoimmune conditions (toxic epidermal necrolysis and mucous membrane pemphigoid) presented with end-stage ocular disease.
• Both patients received Boston keratoprostheses.
• Both patients experienced significant complications, including numerous corneal melts.

Findings:

• The patients required multiple repeat keratoprosthesis implantations due to recurrent corneal melts.
• Outcomes for patients with autoimmune-related corneal blindness treated with keratoprostheses were poor.
• Corneal melts represent a significant challenge in these patient populations.

Implications:

• Available surgical treatments for autoimmune-related corneal blindness may be insufficient.
• Further research into prosthetic device complications in autoimmune diseases is warranted.
• Perioperative immunomodulatory regimens tailored to specific autoimmune diseases could improve outcomes.