Traumatic wound rupture after Boston type 1 keratoprosthesis implantation

To describe the incidence, characteristics, causes, treatment, and outcomes of traumatic wound rupture in patients with Boston type 1 keratoprosthesis (KPro).

Retrospective case series.

We studied 136 eyes of 122 patients who underwent KPro implantation at a single institute between November 2004 and May 2011.

A chart review was performed to determine the incidence, characteristics, causes, treatments, and outcomes of traumatic wound rupture.

The 4 eyes of 4 patients that sustained traumatic wound rupture resulted in an incidence of traumatic wound rupture of 2.9% (4/136). This complication occurred, on average, at 4.2 months (range, 1-9 months) after the KPro was implanted. All ruptures occurred at the graft-host junction. The 2 eyes that had complete keratoprosthesis extrusion experienced decreased vision postrupture, from hand motions to no light perception, and 20/300 to count-fingers vision, respectively. One eye that had 4 clock hours of superior wound rupture recovered vision postrupture from light perception to 20/40. One eye that had 2 clock hours of superior wound rupture maintained a stable vision of 20/125 after repair.

The incidence of traumatic wound rupture after keratoprosthesis is comparable to that after penetrating keratoplasty. Patients should be aware that traumatic rupture is a lifelong concern and should use protective measures to prevent this complication from occurring.