Primary Implantation of Type I Boston Keratoprosthesis in Nonautoimmune Corneal Diseases

Purpose: The aim of this study was to report outcomes of type I Boston keratoprosthesis (KPro) as primary corneal surgery in nonautoimmune corneal disorders. Methods: In this retrospective, observational, large single-center case series of 43 eyes (37 patients) that were followed for an average of 39 months (1–6 years), primary implantation of the type I Boston KPro was performed in all patients. Visual acuity at year 1, visual acuity at last follow-up, and postoperative complication rates were examined for all eyes. Results: Preoperative best-corrected visual acuity ranged from 20/60 to light perception, with vision of 20/200 or worse in 88%. Vision was ≥20/200 at 1 year in 77% of eyes (P < 0.0001). Complications included retroprosthetic membrane formation (51%), glaucoma progression (47%), corneal melt (19%), and sterile vitritis (14%). Conclusions: In a large series with long follow-up, primary Boston KPro effectively restored vision. Close follow-up is needed to manage the known complications after Boston KPro.

[1]  A. Shukla,et al.  Wound Anatomy After Type 1 Boston KPro Using Oversized Back Plates , 2013, Cornea.

[2]  N. Allemann,et al.  Retroprosthetic membrane and risk of sterile keratolysis in patients with type I Boston Keratoprosthesis. , 2013, American journal of ophthalmology.

[3]  M. S. Cortina,et al.  Visual Outcomes of Boston Keratoprosthesis Implantation as the Primary Penetrating Corneal Procedure , 2012, Cornea.

[4]  J. Stein,et al.  Glaucoma Associated With Boston Type I Keratoprosthesis , 2012, Cornea.

[5]  S. Melki,et al.  Intraocular pressure measurement by radio wave telemetry. , 2011, Investigative ophthalmology & visual science.

[6]  Liqiang Wang,et al.  Biocompatibility and biofilm inhibition of N,N-hexyl,methyl-polyethylenimine bonded to Boston Keratoprosthesis materials. , 2011, Biomaterials.

[7]  C. A. Utine,et al.  Clinical Features and Prognosis of Boston Type I Keratoprosthesis-associated Corneal Melt , 2011, Ocular immunology and inflammation.

[8]  M. Mannis,et al.  Longer-term vision outcomes and complications with the Boston type 1 keratoprosthesis at the University of California, Davis. , 2011, Ophthalmology.

[9]  K. Colby,et al.  Expanding indications for the Boston keratoprosthesis , 2011, Current opinion in ophthalmology.

[10]  J. Chodosh,et al.  Titanium back plate for a PMMA keratoprosthesis: clinical outcomes , 2011, Graefe's Archive for Clinical and Experimental Ophthalmology.

[11]  N. Michaud,et al.  Characterization of retrokeratoprosthetic membranes in the Boston type 1 keratoprosthesis. , 2011, Archives of ophthalmology.

[12]  J. Chodosh,et al.  Expanding Application of the Boston Type I Keratoprosthesis Due to Advances in Design and Improved Post-operative Therapeutic Strategies , 2010, Seminars in ophthalmology.

[13]  M. Klufas,et al.  The Boston Keratoprosthesis , 2010, International ophthalmology clinics.

[14]  I. Gipson,et al.  The Boston Keratoprosthesis: Comparing Corneal Epithelial Cell Compatibility with Titanium and PMMA , 2009, Cornea.

[15]  R. Langer,et al.  A drug-eluting contact lens. , 2009, Investigative ophthalmology & visual science.

[16]  F. Yu,et al.  The Boston type I keratoprosthesis: improving outcomes and expanding indications. , 2009, Ophthalmology.

[17]  J. Folch,et al.  Type I Boston keratoprosthesis with cataract extraction and intraocular lens placement for visual rehabilitation of herpes zoster ophthalmicus: the “KPro Triple” , 2009 .

[18]  K. Hammersmith.  The Boston Type I Keratoprosthesis: Improving Outcomes and Expanding Indications , 2009 .

[19]  Rony R. Sayegh,et al.  The Boston keratoprosthesis in Stevens-Johnson syndrome. , 2008, American journal of ophthalmology.

[20]  S. Al-Swailem,et al.  Graft failure: II. Ocular surface complications , 2008, International Ophthalmology.

[21]  R. Pineda,et al.  Outcomes of Boston keratoprosthesis in aniridia: a retrospective multicenter study. , 2007, American journal of ophthalmology.

[22]  Claes H Dohlman,et al.  Importance of Nutrition to Corneal Grafts When Used as a Carrier of the Boston Keratoprosthesis , 2007, Cornea.

[23]  D. Pavan-Langston,et al.  The Boston keratoprosthesis in herpetic keratitis. , 2007, Archives of ophthalmology.

[24]  J. Scott,et al.  Therapeutic keratoplasty for advanced suppurative keratitis. , 2007, American journal of ophthalmology.

[25]  Danish M. Khan,et al.  Advances in Boston Keratoprosthesis: Enhancing Retention and Prevention of Infection and Inflammation , 2007, International ophthalmology clinics.

[26]  James V Aquavella,et al.  Introduction to the use of the Boston keratoprosthesis , 2006 .

[27]  M. Belin,et al.  Results from the multicenter Boston Type 1 Keratoprosthesis Study. , 2006, Ophthalmology.

[28]  I. Wang,et al.  Therapeutic penetrating keratoplasty for microbial keratitis in Taiwan from 1987 to 2001. , 2004, American journal of ophthalmology.

[29]  Robert W. Thompson,et al.  Long-term graft survival after penetrating keratoplasty. , 2003, Ophthalmology.

[30]  F. Verbraak,et al.  The Influence of Keratoplasty on Visual Prognosis in Aniridia: A Historical Review of One Large Family , 2003, Cornea.

[31]  M. Böhnke,et al.  The outcome of corneal grafting in patients with stromal keratitis of herpetic and non-herpetic origin , 2002, The British journal of ophthalmology.

[32]  W. Feuer,et al.  Long-term outcome of keratolimbal allograft with or without penetrating keratoplasty for total limbal stem cell deficiency. , 2002, Ophthalmology.

[33]  B. Khan,et al.  Protection of the ocular surface after keratoprosthesis surgery: the role of soft contact lenses. , 2002, The CLAO journal : official publication of the Contact Lens Association of Ophthalmologists, Inc.

[34]  T. Oshika,et al.  Risk factors for corneal graft failure and rejection in penetrating keratoplasty. , 2001, Acta ophthalmologica Scandinavica.

[35]  M. Durand,et al.  Endophthalmitis after keratoprosthesis: incidence, bacterial causes, and risk factors. , 2001, Archives of ophthalmology.

[36]  U. Rehany,et al.  The profile of repeated corneal transplantation. , 2001, Ophthalmology.

[37]  M. Doane,et al.  Keratoprosthesis: Preoperative Prognostic Categories , 2001, Cornea.

[38]  P. Netland,et al.  Glaucoma associated with keratoprosthesis. , 1998, Ophthalmology.

[39]  N. Ehlers,et al.  Graft survival and risk factors of penetrating keratoplasty for microbial keratitis. , 2009, Acta ophthalmologica Scandinavica.

[40]  E. Cohen,et al.  Recurrent keratopathy after penetrating keratoplasty for aniridia. , 1996, Cornea.

[41]  R. D. Stulting,et al.  Risk factors for corneal graft failure and rejection in the collaborative corneal transplantation studies. Collaborative Corneal Transplantation Studies Research Group. , 1994, Ophthalmology.

[42]  E. Cohen,et al.  Results of penetrating keratoplasty in aniridia. , 1993, American journal of ophthalmology.

[43]  G. Naumann.  Corneal transplantation for herpes simplex keratitis. , 1983, American journal of ophthalmology.

[44]  D. Coster,et al.  Prognosis and management of corneal transplantation for herpetic keratitis. , 1980, Archives of ophthalmology.