Advancements In Ocular Rehabilitation: A Case Report Of Comprehensive Care With Boston Type 1 Keratoprosthesis Integration

To present a case of a 53-year-old male with a 4-year history of chemical injury to the right eye, highlighting the efficacy of a staged approach in vision restoration through comprehensive care.

The patient sustained accidental chemical injury with concentrated acetic acid in 2018 and initially received primary treatment in his country, where evisceration was recommended but declined. Upon  presentation to our clinic in April 2022, the patient had dense fibrovascular tissue covering the entire ocular surface, was very unhappy with the cosmetic appearance.The visual acuity was OD= light perception ,  B-Scan without pathology.

The patient underwent ocular surface reconstruction with oral mucosal transplantation. Seven months later, a Boston Type 1 keratoprosthesis (Kpro) procedure was performed. Postoperative visual acuity improved to OD=20/80.

Following ocular surface reconstruction and Kpro surgery, the patient's visual acuity improved significantly from light perception to OD=20/80. Over the 16-month follow-up period, the condition of the eye remained stable, indicating the success of the multidisciplinary approach employed in managing the ocular surface injury.

This case highlights the efficacy of a staged approach in restoring vision following severe ocular surface injury. Despite initial challenges and recommendations for evisceration, the patient's vision was successfully rehabilitated through ocular surface reconstruction and subsequent Kpro surgery. Such cases demonstrate the importance of comprehensive care, resulting not only in the improvement of cosmetic appearance but also in regaining useful vision.