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Long-term visual outcomes and complications of Boston type 1 keratoprosthesis (KPro) as a primary surgical modality

Poster Details

First Author: M.Cortina USA

Co Author(s):    K. Kang   R. Rai   J. Kang   A. Yeung   J. De la Cruz   F. Karas     

Abstract Details


Despite improved retention and reduced complication rates paving the way for the current expansion of applications and surge in prevalence for the Boston type I Keratoprosthesis (KPro), the most frequent indication for its placement today remains prior graft failure. Our study evaluates the use of KPro as the therapy of choice, as opposed to its historical use as a rescue therapy, among patients with a poor prognosis for conventional corneal transplantation.


University of Illinois at Chicago (UIC), Eye and Ear Infirmary.


Retrospective analysis of a cohort of patients who underwent KPro implantation in a single center by two surgeons between July 2008 and October 2014 were included. Patients with fewer than 12 months of follow-up or a history of prior penetrating or lamellar corneal transplant were excluded


Twenty-eight eyes of 26 patients (mean age 49.3) were included. Mean follow up was 57.9 months. Of these eyes, 29% had a diagnosis of physical injuries, 25% aniridia, 21% autoimmune disease, 11% infectious keratitis, 7% corneal amyloidosis, 7% ectrodactyly ectodermal dysplasia, and 4% hypotony. Preoperatively, 54% had BCVA of �â�‰�¥ CF to < 20/200, and 43% �â�‰�¥ LP to < CF. Eighteen percent of these eyes achieved a final BCVA of �â�‰�¥ 20/50 and 61% achieved BCVA of �â�‰�¥ 20/200. Most common complications were RPM (46%), raised IOP (68%), extrusion (32%), CME (21%), ERM (21%), retinal detachment (11%), endophthalmitis (11%).


This study demonstrates that Boston KPro implantation may be successful as a primary procedure in patients at high risk of failure with traditional PK. The device has a good long term retention rate (75% at 4 years) and visual outcomes are promising however a larger study is needed for more definitive results.

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