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Boston type 1 keratoprosthesis for failed keratoplasty

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Abstract

The purpose of this study was to evaluate the outcomes of the Boston type 1 keratoprosthesis (Kpro-1) in eyes with failed keratoplasty. A retrospective review was performed of every patient treated with a Kpro-1 at a tertiary eye care center between January 1, 2008 and July 1, 2013. Eyes with a failed keratoplasty originally performed for corneal edema, trauma, or keratoconus were included in the statistical analysis. The main outcome measures were visual outcome, prosthesis retention, and postoperative complications. Twenty-four eyes met the inclusion criteria, including 13 eyes with corneal edema, 8 eyes with trauma, and 3 eyes with keratoconus. After a mean follow-up period of 28.9 months (range 7–63 months), the median best corrected visual acuity (BCVA) was 20/125. The BCVA was ≥20/40 in 4 (16.7 %) eyes, ≥20/70 in 9 (37.5 %) eyes, and ≥20/200 in 14 (58.3 %) eyes. Overall, the postoperative BCVA improved in 17 (70.9 %) eyes, was unchanged in 3 (12.5 %) eyes, and was worse in 4 (16.7 %) eyes. The initial Kpro-1 was retained in 22 (91.7 %) eyes, and was successfully repeated in the other 2 eyes. One or more serious prosthesis- or sight-threatening complications occurred in 8 (33.3 %) eyes. These included 1 case of wound dehiscence leading to prosthesis extrusion, 1 case of fungal keratitis leading to prosthesis extrusion, 4 cases of endophthalmitis, and 5 retinal detachments. The Boston Kpro-1 is associated with an excellent prognosis for prosthesis retention and satisfactory visual improvement in eyes with previous failed keratoplasty.

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Acknowledgments

All authors participated in the experimental design, collections and analysis of the data, preparation of the manuscript, and review and approval of the final document. None of the authors have any financial interests to disclose. There was no external funding or other sources of financial support for this project.

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA, 52242-1091, USA

    Jonathan L. Hager, David L. Phillips, Kenneth M. Goins, Anna S. Kitzmann, Mark A. Greiner, Jeffrey D. Welder & Michael D. Wagoner

  2. Department of Ophthalmology and Visual Sciences, Dean McGee Eye Institute, University of Oklahoma School of Medicine, Oklahoma City, OK, USA

    Alex W. Cohen

  3. Cornea Research Center, Stephen A Wynn Institute for Vision Research, 375 Newton Road, Iowa City, IA, 52242-1091, USA

    Mark A. Greiner & Michael D. Wagoner

  4. Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242-1091, USA

    Jonathan L. Hager, David L. Phillips, Kenneth M. Goins, Anna S. Kitzmann, Mark A. Greiner, Jeffrey D. Welder & Michael D. Wagoner

Authors
  1. Jonathan L. Hager
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  2. David L. Phillips
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  3. Kenneth M. Goins
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  4. Anna S. Kitzmann
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  5. Mark A. Greiner
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  6. Alex W. Cohen
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  7. Jeffrey D. Welder
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  8. Michael D. Wagoner
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Corresponding author

Correspondence to Michael D. Wagoner.

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Hager, J.L., Phillips, D.L., Goins, K.M. et al. Boston type 1 keratoprosthesis for failed keratoplasty. Int Ophthalmol 36, 73–78 (2016). https://doi.org/10.1007/s10792-015-0078-2

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  • DOI: https://doi.org/10.1007/s10792-015-0078-2

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