Vitreoretinal Complications in Two Designs of Type 1 Keratoprosthesis

To report the incidence and spectrum of vitreoretinal complications (VRCs) in consecutive patients implanted with 2 designs of type 1 keratoprosthesis (KPro).

Retrospective analysis of electronic medical records. Demographic and clinical data were collected from patients who developed VRCs. The main outcome measure was the proportion of VRCs and their management.

Eighty-four eyes from 81 patients with KPro were analyzed (Boston = 28; Lucia = 56). VRCs occurred in 32 cases (38.10%). The mean age of patients with VRCs was 55.15 ± 16.67 years (range: 27-90), and the mean follow-up duration was 33.90 ± 16.31 months. The most frequent VRC was retroprosthetic membrane formation requiring pars plana vitrectomy (n = 10, 11.90%), followed by retinal detachment (n = 9, 10.71%), choroidal detachment (n = 8, 9.52%), endophthalmitis (n = 8, 9.52%), vitreous hemorrhage (n = 7, 8.33%), cystoid macular edema (n = 2, 2.38%), asteroid hyalosis (n = 1, 1.19%), epiretinal membrane (n = 1, 1.19%), macular atrophy (n = 1, 1.19%), and sterile vitritis (n = 1, 1.19%). The median best-corrected visual acuity (BCVA) achieved after KPro implantation was 0.6 LogMAR (IQR: 0.18-1.3); in contrast, the median BCVA after any VRC was 2.4 LogMAR (IQR: 0.58-2.7). In all cases (100%), VRCs led to a deterioration in BCVA. Anatomical failure occurred in 7 cases (21.88%) and functional failure in 20 cases (62.50%), after a mean duration of 8.83 months.

VRCs occurred in 38.10% of cases after type 1 KPro implantation and were associated with poorer outcomes, including increased anatomical and functional failure.