Clinical Outcomes After Boston Type I/Lucia Keratoprosthesis Implantation: Visual Acuity And Postoperative Complications
Published 2026 - 44th Congress of the ESCRS
Reference: FP22.14 | Type: Free paper | DOI: 10.82333/y9ve-5p21
Authors: Prof. Dr Luis Izquierdo Jr* 1 , Tatiana Andrea Arévalo-Barboza 2 , A/Prof. Maria A. Henriquez 2
1Research department,Oftalmosalud Institute of Eyes,Lima,Peru;San Fernando School of Medicine,Universidad Nacional Mayor de San Marcos,Lima,Peru, 2Research department,Oftalmosalud Institute of Eyes,Lima,Peru
Purpose
To evaluate visual outcomes and postoperative complications after Boston Type I and/or Lucia keratoprosthesis (Kpro) implantation.
Setting
Oftalmosalud Institute, Lima, Peru.
Methods
Retrospective cohort including 44 eyes (44 patients) undergoing Boston Type I and/or Lucia keratoprosthesis implantation between 2023 and 2025 (Boston Type I n=38, Lucia n=6). Demographics, ocular surface status (wet/dry), indication/etiology, prior corneal grafting, and ocular comorbidities were collected. CDVA (logMAR) was recorded preoperatively, at last follow-up (final CDVA), and as best postoperative CDVA during follow-up; conventional logMAR assignments were used for non-quantifiable vision when applicable. Postoperative adverse events were classified as anterior segment/ocular surface, inflammatory–infectious, vitreoretinal/posterior segment, prosthesis/optical-related, and glaucoma-related.
Results
Forty-four eyes were included; 61.36% were male; mean age was 52.48±20.59 years; mean follow-up was 11.02±7.24 months. Prior corneal grafting was present in 70.45%. Ocular surface status was wet in 72.73% and dry in 27.27%. Indications were graft failure/rejection (50.00%), infectious keratopathy (15.91%), chemical injury (11.36%), trauma (9.09%), and autoimmune disease (9.09%). Preoperative CDVA was 2.04±0.56 logMAR (0.70–2.70). Final CDVA was 1.44±0.97 logMAR (0.00–3.00), and best postoperative CDVA was 1.03±0.94 logMAR (0.00–3.00). At last follow-up, 72.73% achieved CDVA ≥20/200 and 20.45% achieved ≥20/60. The most common complication was RPM (optical-related; 35%), with posterior segment and glaucoma-related events each (17.39%).
Conclusions
Most eyes achieved functional vision at last follow-up (73% ≥20/200) in this high-complexity Kpro cohort with frequent prior grafting. Best postoperative CDVA exceeded final CDVA, consistent with visual fluctuation over time and the impact of postoperative adverse events. Prosthesis/optical-related events were most frequent, with RPM as the most common specific complication, supporting careful patient selection and close multidisciplinary follow-up.