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Updated: Oct 17, 2025
Techniques for Processing Eyes Implanted With a Retinal Prosthesis for Localized Histopathological Analysis
Published on: August 2, 2013
Retroprosthetic Membrane Formation in Boston Keratoprosthesis Type 1: Incidence, Predisposing Factors, Complications,
Diana Khair1, Roy Daoud, Mona Harissi-Dagher
1Department of Ophthalmology, Université de Montréal, Montréal, Québec, Canada.
Purpose:
The purpose of this study was to evaluate the incidence, rate of formation, and risk factors of retroprosthetic membrane (RPM) after Boston type 1 keratoprosthesis (BKPro) as well as identify secondary complications linked to its formation and describe its treatment.
Methods:
This was a retrospective cohort study. One hundred thirty-three eyes of 115 patients who underwent BKPro implantation at the Centre Hospitalier de l'Université de Montréal from 2008 to 2017 were included with at least 1-year follow-up. Charts were reviewed, and data were collected, including incidence of RPM formation, preoperative and intraoperative risk factors, postoperative complications, and treatment modalities.
Results:
The mean follow-up was 5.5 years, and 39% (n = 52) of eyes developed RPM. No etiologies were found to be significantly associated with RPM development. Simultaneous lensectomy and simultaneous intraocular lens extraction were respectively positively and negatively correlated with RPM development [odds ratio (OR): 0.3590, 95% CI: 0.1629-0.7570, P = 0.0097; OR = 2.646, 95% CI: 1.273-5.585, P = 0.0086, respectively]. As for postoperative complications, the strongest correlation was between RPM and retinal detachment (OR = 6.16, 95% CI: 2.14-16.14; P = 0.0004). RPM development was also positively associated with the development of hypotony and corneal melt. Nd:YAG membranectomy was the most common treatment, performed in 83% of eyes with RPM (n = 24), with 58% resolution.
Conclusions:
More than one third of patients who undergo BKPro will develop RPM, requiring close monitoring for retinal detachment. Simultaneous intraocular lens extraction seems protective, whereas simultaneous lens extraction increases the rate of RPM formation significantly. Nd:YAG membranectomy can be used as an initial noninvasive approach.
Insights
Retroprosthetic membrane (RPM) affects 39% of patients after Boston type 1 keratoprosthesis (BKPro) implantation. Monitoring for retinal detachment is crucial, and Nd:YAG membranectomy offers a potential treatment.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Prosthetic Eye Implants
Background:
- Boston type 1 keratoprosthesis (BKPro) is a treatment for corneal blindness.
- Retroprosthetic membrane (RPM) formation is a known complication after BKPro implantation.
- Understanding RPM incidence, risk factors, and outcomes is vital for patient management.
Purpose of the Study:
- To determine the incidence and formation rate of RPM after BKPro.
- To identify preoperative and intraoperative risk factors for RPM development.
- To analyze secondary complications and treatment outcomes for RPM.
Main Methods:
- Retrospective cohort study of 133 eyes (115 patients) with BKPro.
- Data collected included RPM incidence, risk factors, complications, and treatments.
- Minimum 1-year follow-up was required for inclusion.
Main Results:
- 39% of eyes developed RPM with a mean follow-up of 5.5 years.
- Simultaneous lens extraction increased RPM risk (OR=2.65), while intraocular lens extraction decreased it (OR=0.36).
- RPM was strongly associated with retinal detachment (OR=6.16), hypotony, and corneal melt. Nd:YAG membranectomy resolved RPM in 58% of cases.
Conclusions:
- Over one-third of BKPro patients develop RPM, necessitating vigilant monitoring for complications like retinal detachment.
- Simultaneous lens extraction is a risk factor, whereas intraocular lens extraction appears protective against RPM.
- Nd:YAG membranectomy is an effective initial noninvasive treatment for RPM.
