Evaluation of the Stability of Boston Type I Keratoprosthesis–Donor Cornea Interface Using Anterior Segment Optical Coherence Tomography
Bibliographic record
Abstract
PURPOSE: To evaluate the anatomic stability of an implanted Boston type I keratoprosthesis (KPro)-donor cornea interface and assess the presence or absence of a potential space (gap) between the KPro front plate and donor cornea using anterior segment optical coherence tomography (AS-OCT). The presence of a gap would raise concerns of a possible pathway for the exchange of extraocular fluid with the anterior chamber. METHODS: Fifteen eyes implanted with a Boston type I KPro were studied by the noncontact technique of AS-OCT (AC Cornea OCT prototype; OTI, Canada). All the KPro devices had been implanted at least 4 weeks before the study (mean: 7 months, range: 1-22 months). Eight eyes had aphakic Kpros, and the other 7 had pseudophakic implants. Anesthetized eyes were imaged before and during pressure application using sterile cotton-tip applicators. Pressure was applied for 10 seconds on the nasal or temporal side of the eye. Images were analyzed for any possible changes in the KPro-donor cornea interface during the application of pressure. RESULTS: Of 15 eyes, 10 had the threaded front plate model with a T-shaped silhouette and corrugated sides, whereas 5 had the threadless type with a T-shaped silhouette and smooth sides on cross-sectional optical coherence tomography. Of the 15 eyes, 2 revealed a gap between the front plate and the surface of the donor cornea. The rest revealed no gaps. With pressure, none of the eyes, including the 2 with gaps, demonstrated any change in the KPro-donor cornea interface during dynamic imaging (eg, gaping or evidence of fluid escape along the KPro-donor cornea borders). In all eyes, the position of the titanium locking ring was visible and verified to be in an adequate position. CONCLUSIONS: The implanted KPro-donor cornea interface seems to be stable dynamically using AS-OCT. A gap that has been documented with this imaging tool showed neither gaping nor escape of anterior chamber fluid during dynamic cross-sectional imaging. Further studies will be needed to assess the cause of these gaps and to determine if they are possibly related to the hydration status of the cornea, suture tension on the donor cornea, or other factors that remain to be determined.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".