Biomedical subjects

James V Aquavella

Publications and source records attributed to James V Aquavella.

2 recordsLinked to original sources

PubMed2006

Keratoprosthesis: current techniques.

PURPOSE: To compare and contrast the techniques and results of keratoprosthesis (KPro) using the Cardona device (1975-1985) with those related to the use of the Dohlman-Doane type 1 device (2003-2005). METHODS: We conducted a retrospective review of 31 cases of Cardona KPro implanted between 1975 and 1981 and a review of 25 cases of Dohlman-Doane type 1 KPro implanted between 2003 and 2005. Procedures were limited to eyes with a poor prognosis for traditional penetrating keratoplasty. RESULTS: In the Cardona cases, 39% (12/31) of patients achieved a visual acuity of 20/40 or better at some point postoperatively, degrading to 16% (5/31) at the end of the observation period. Fifty percent (15/31) required subsequent surgical revision of the KPro. Sixteen percent of cases (5/31) developed endophthalmitis, and 58% (18/31) developed retroprosthetic membranes. There were 5 dislocations of the prosthesis and an additional 3 frank extrusions (26%). Of the 25 Dohlman-Doane cases, there have been no reoperations, endophthalmitis, dislocations, or extrusions to date (8/15/05). Forty-eight percent (12/25) achieved 20/200 acuity or better, and 12% (3/25) achieved 20/40 or better. Retroprosthetic membranes formed in 3 cases. CONCLUSION: Although KPro remains a technique to be used in poor prognosis keratoplasty, improvements in the design of the device and surgical technique over the past 30 years have reduced the overall morbidity and severity of complications and improved the prognosis for visual rehabilitation.

Adolescent↗

PubMed2005

Keratoprosthesis: the Dohlman-Doane device.

PURPOSE: To determine the usefulness of the Dohlman-Doane type I keratoprosthesis for visual rehabilitation in cases of poor prognosis for traditional penetrating keratoplasty. DESIGN: A retrospective, noncomparative interventional series of 25 patients who had sustained multiple graft failure or who were otherwise deemed poor candidates for conventional keratoplasty. METHODS: Candidates were evaluated for potential acuity, intraocular pressure, inflammation, the quality of the ocular surface, and overall prognosis for penetrating keratoplasty. The keratoprosthesis was assembled and mounted on an 8.5- or 9.0-mm diameter donor corneal button and sutured into an 8.0- or 8.5-mm diameter recipient bed with 12 to 16 9-0 nylon sutures. Patients were examined on the first day and subsequently in 1 week and 1 month and then at 3-month intervals. RESULTS: All devices were retained without dislocation or extrusion. There were no instances of endophthalmitis or surface infection. Fundus details were visible on the first postoperative day. Patients achieved their best acuity in an average of 2 months (range, 1 to 180 days). Improvement in acuity was observed in an average of 13 days (range, 1 to 60 days). Retroprosthetic membranes occurred in three cases, with multiple recurrences in one instance. Visual acuity ranged from no light perception to 20/25. CONCLUSION: We conclude that this prosthesis can be implanted routinely and maintained with minimal complications in poor prognosis keratoplasty, which presents the potential for visual rehabilitation.

Adult↗