Long-Term Outcomes Of Type 1 Keratoprosthesis In A Tertiary Care Centre

To evaluate the long-term visual and anatomical outcomes of type 1 keratoprosthesis implantation and to analyze device retention and postoperative complications over extended follow-up in eyes with severe corneal blindness not amenable to conventional keratoplasty.

Retrospective observational study conducted at a tertiary eye care referral center with dedicated cornea and anterior segment services.

This retrospective study included 23 eyes from 20 patients who underwent type 1 keratoprosthesis implantation with a minimum follow-up of 5 years. Indications included multiple failed corneal grafts, chemical injury, recurrent viral keratitis, blast injury, and ocular cicatricial pemphigoid. Outcome measures assessed were visual acuity in logMAR units, device retention, and incidence of postoperative complications.

Twenty-three eyes from 20 patients, with a mean age of 46.65 years and a mean follow-up of 8.1 years, were analyzed. Seventy percent were male. Mean preoperative visual acuity was logMAR 2.58. Immediate postoperative mean visual acuity improved to logMAR 1.07, and long-term mean visual acuity was logMAR 1.89. Common complications included infectious keratitis, endophthalmitis, retroprosthetic membrane formation, and carrier graft melts.

Type 1 keratoprosthesis provides significant short-term visual improvement in eyes with complex corneal pathology; however, long-term visual outcomes may decline due to sight-threatening complications. Careful long-term monitoring is essential to optimize device retention and manage postoperative complications, thereby improving overall prosthesis survival and patient outcomes.