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Stromal Melting Associated With a Cosmetic Contact Lens Over a Boston Keratoprosthesis: Treatment With a Conjunctival Flap

Adesina, Ore-ofe O. M.D.; Vickery, Jean A. F.C.L.S.A.; Ferguson, Carri L. F.C.L.S.A.; Stone, Donald U. M.D.

doi: 10.1097/ICL.0b013e31824daad2
Case Report

Objectives: The aim was to discuss the use of a conjunctival flap for treatment of keratolysis of a keratoprosthesis (Kpro) donor graft in a patient fitted with a cosmetic contact lens.

Methods: Keratolysis developed in the donor graft of a Boston Kpro; this was associated with the use of a cosmetic contact lens. A conjunctival flap was used to stabilize the graft. The literature is reviewed for similar cases, and the rationale for the intervention is described and discussed.

Results: Reinforcement of the graft with a conjunctival flap resulted in an arrest in stromal melting and stabilization of visual acuity.

Conclusions: Low Dk opaque contact lenses may be a risk factor for keratolysis after Kpro. A conjunctival flap technique can provide stabilization of keratolysis with arrest of corneal melting and merits further study.

Department of Ophthalmology (O.O.A., D.U.S.), University of Oklahoma; and Dean McGee Eye Institute (J.A.V., C.L.F., D.U.S.), Oklahoma City, OK.

Address correspondence and reprint requests to Donald U. Stone, M.D., 608 S.L. Young Boulevard, Oklahoma City, OK 73106; e-mail:

The authors have no funding or conflicts of interest to disclose.

Accepted January 30, 2012

© 2013 Contact Lens Association of Ophthalmologists, Inc.