Analysis of clinic results and complication associated with Boston I keratoprosthesis

Objective: This study was to evaluate clinical results and complications associated with the Boston type I keratoprosthesis implanted into complex corneal opacity.

Methods: Retrospective study. Sixty-one eyes (57 cases) received Boston type I KPro implantation between May 2011 and January 2013 in the Chinese PLA General Hospital, and were followed for at least 2 months (range, 2 to 27 months, mean 19 months). Indications for keratoprosthesis included thermal injury (n = 17), chemical injury (n = 19), herpetic keratitis (n = 8), blast injury (n = 6), keratitis (n = 8), antoimmune diseases (n = 2) and corneal endothelial decompensation (n = 9). Kpro implantation in accordance with the Massachusetts Eye Center standardized surgical approach, and routine lens removal meantime. Clinical complications and postoperative treatments were recorded.

Results: Preoperative visual acuity were light perception to the counting figure in all the patients. Forty-seven eyes (77%) had better best correct visual acurity than counting figure and 18 eyes (30%) had BCVA better than 0.3 after implantation. Postoperative complications indluded carrier corneal melting (10 cases), retroprothesis membrane (6 cases), glaucoma (12 cases), retinal detachment (2 cases), choroidal detachment (1 case), endophthalmitis (2 cases). Complications take symptomatic treatment, in addition to glaucoma patients and two cases of endophthalmitis patients (Evisceration), all patients can maintain the original best corrected visual acuity.

Conclusions: Timely examination of the KPro and replacement with donor cornea may prevent a poor outcome. Close follow-up is necessary after KPro-implantation.