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Short-Term Outcomes of Modified Boston Type-II Keratoprosthesis Implantation With Autologous Auricular Cartilage
1From the National Clinical Research Center for Ocular Diseases (M.L., H.W., L.L., C.G., L.G., Q.Z., W.C.), Eye Hospital, Wenzhou Medical University, Wenzhou, China; Department of Ophthalmology (M.L., L.G., W.C.), Boao Super Hospital, Hainan, China.
Purpose:
To report the short-term visual outcomes and complications of a modified Boston Type-II keratoprosthesis (Kpro) procedure.
Design:
Retrospective case series.
Methods:
Thirty-seven eyes of 37 patients who had an implantation of autologous auricular cartilage-reinforced (AACR) Boston Type-II Kpro (BK2) were included in the current study. Preoperative and postoperative data were recorded and analyzed for each eye. Main outcome measures included best-corrected visual acuity, symptoms as assessed by questionnaires, complications associated with implantation, and retention of the implanted BK2 device.
Results:
A total of 37 eyes, consisting of 19 with severe autoimmune dry eye (ADE) and 18 with burn injury, completed ≥12 months of follow-up. The median (interquartile range) best-corrected visual acuity at baseline, 1 month, 3 months, 6 months, 1 year, and 2 years of follow-up was hand motion (HM) 20/60 (20/100-20/40), 20/60 (20/200-20/40), 20/60 (20/200-20/40), 20/100 (20/200-20/40), and 20/100 (20/400-20/40), respectively. All eyes retained the initial device (37/37, 100%). Common postoperative complications included retroprosthetic membrane (n = 21), de novo glaucoma (n = 7), endophthalmitis (n = 1), and conjunctival erosion (n = 4). No ear complications were discovered during follow-up assessments. The ocular surface disease index score improved from baseline to a 2-year follow-up (median 57.5 vs 21.43).
Conclusion:
The modified AACR-BK2 procedure could be considered to restore vision in patients with end-stage corneal blindness.
