Boston keratoprosthesis restoring vision in an unusual case of end-stage limbal stem cell deficiency following exposure to Euphorbia latex

• Published in: International ophthalmology 2012-02, Vol.32 (1), p.77-79
• Main Authors: Dutta, Jayanta, Mukhopadhyay, Somnath, Datta, Himadri, Sen, Swarnali
• Format: Article
• Language: English
• Subjects: Artificial Organs; Case Report; Corneal Diseases - chemically induced; Corneal Diseases - pathology; Corneal Diseases - surgery; Corneal Transplantation - methods; Euphorbia; Follow-Up Studies; Humans; Limbus Corneae - drug effects; Limbus Corneae - pathology; Limbus Corneae - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; Plant Exudates - adverse effects; Prosthesis Design; Recovery of Function; Stem Cells - drug effects; Stem Cells - pathology; Visual Acuity - physiology
• ISSN: 0165-5701; 1573-2630
• DOI: 10.1007/s10792-012-9515-7

We report the functional outcome of a patient who had undergone Boston keratoprosthesis type I for extensive ocular surface damage caused by latex of Euphorbia. The milky sap or latex of the Euphorbia plant is highly toxic and an irritant to the skin and eye. Damage to the eye ranges from mild to severe corneal edema, epithelial defects, anterior uveitis, secondary elevated intraocular pressure and, rarely, limbal stem cell deficiency with corneal neovascularization. A restrospective review was conducted of this patient for more than 1 year. During this period he was given subconjunctival bevacizumab injection to regress the corneal vascularization without much benefit, before finally performing Boston keratoprosthesis type I. The patient was evaluated periodically for both anatomical and visual outcome. At the end of 1-year follow-up the keratoprosthesis is well retained with a best-corrected visual acuity of 20/40 in the affected eye.