Dear Editor,

We read with interest the comments about our article by Kwitko and associates. We agree with the authors that B-Kpro implantation is a valid option for visual rehabilitation in patients with a severely damaged ocular surface secondary to ocular burns, as is clearly emphasized in the discussion section (first and last paragraphs below).

Discussion section:

First paragraph: “This study confirmed that B-Kpro implantation is a valid option for visual rehabilitation in patients with a severely damaged ocular surface secondary to ocular burns, and this finding is in agreement with findings of relevant studies.”

Last paragraph: “In summary, the anatomical and functional results in this study indicated the capability of B-Kpro for visual rehabilitation in patients with thermal or chemical ocular burns, who have experienced unsuccessful treatment for vision loss.”

While we understand the authors’ concern of irreversible visual loss in this population, their interpretation must be analyzed with discretion. We concluded that “type I Boston KPro is a continuous thread that may result in irreversible visual loss in this population” as referred in their letter. Our conclusion in the abstract section is: “The anatomical and functional results support the use of B-Kpro for managing bilateral limbal stem cell deficiency secondary to ocular burns. However, glaucoma should be carefully evaluated, as it is a continuous threat that may result in irreversible visual loss in this population.” Even though this point was clear in the abstract (conclusion section), we would like to clarify that we had mentioned glaucoma as a continuous threat during follow-up of these patients as already pointed out by other authors⁽¹⁾.

REFERENCE

1. Cade F, Grosskreutz CL, Tauber A, Dohlman CH. Glaucoma in eyes with severe chemical burn, before and after keratoprosthesis. Cornea. 2011;30(12):1322-7.