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Boston Type 1 Keratoprosthesis: Visual Outcomes, Device Retention, and Complications
Kenneth M Goins1, Anna S Kitzmann, Mark A Greiner
1*Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, University of Iowa Carver College of Medicine, Iowa City, IA; †Cornea Research Center, Stephen A. Wynn Institute for Vision Research, Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA; and ‡Department of Management Services, Tippie College of Business, Iowa City, IA.
Boston type 1 keratoprosthesis (KPro-1) implantation offers good vision and device retention for many patients. However, serious complications are frequent and can impact long-term visual success.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Prosthetic Eye Devices
Background:
- Corneal blindness remains a significant global health issue.
- Boston type 1 keratoprosthesis (KPro-1) offers a solution for patients with severe corneal disease unresponsive to conventional treatments.
Purpose of the Study:
- To evaluate the visual outcomes, device survival, and complication rates following Boston type 1 keratoprosthesis (KPro-1) implantation.
Main Methods:
- Retrospective review of all KPro-1 implantations at a single tertiary eye care center.
- Analysis included 75 eyes without prior keratoprosthesis implantation.
- Data collected on visual acuity, device retention, and postoperative complications.
Main Results:
- Mean visual acuity improved significantly post-KPro-1 implantation (20/1265 to 20/97 at 6 months).
- At mean follow-up of 41.4 months, 62.7% achieved ambulatory vision (≥20/400).
- Device retention was 85.3% initially, with 5-year Kaplan-Meier survival of 82%; however, 68% experienced sight-threatening complications.
Conclusions:
- Boston KPro-1 implantation provides satisfactory visual outcomes and high device retention rates.
- Significant rates of serious postoperative complications, including extrusion, infection, and inflammatory conditions, necessitate careful patient selection and monitoring.
