Wide-angle fundus imaging through the Boston keratoprosthesis

Area of Science:

• Ophthalmology
• Medical Imaging

Background:

• Keratoprosthesis implantation is a surgical procedure to restore vision in patients with severe corneal disease.
• Imaging the peripheral retina in these patients presents unique challenges due to the artificial cornea.

Purpose of the Study:

• To evaluate the feasibility of using three wide-angle fundus cameras for peripheral retinal imaging in eyes with a Type 1 Boston keratoprosthesis.
• To compare the image quality, ease of acquisition, and limitations of noncontact (Optos) and contact (RetCam, Panoret) imaging systems.

Main Methods:

• Noncontact Optos and contact RetCam and Panoret wide-angle imaging systems were used to image the retina in eyes with keratoprosthesis.
• Failure-to-image rates, image quality, field of view, and complications were assessed.
• Optos imaging findings were correlated with ultrasound B-scan results.

Main Results:

• Wide-angle retinal images were successfully obtained with all three cameras in some eyes.
• Optos achieved the highest success rate (all four eyes), followed by RetCam (three eyes) and Panoret (two eyes).
• Optos provided the best image quality and was preferred for its noncontact nature, ease of use, and safety, outperforming B-scan in specific cases.

Conclusions:

• Wide-angle fundus imaging through a keratoprosthesis is feasible with available technologies.
• The noncontact Optos system is a preferred choice due to its superior image quality, ease of use, and patient comfort.
• Optos imaging complements and may surpass ultrasound B-scan for peripheral retinal examination in keratoprosthesis patients.