ArticleJournal of current ophthalmology
Twelve-Month Visual and Anatomical Outcomes of Boston Type I Keratoprosthesis in Four Patients with Multiple Graft Failures and Severe Ocular Pathology.
Article in Journal of current ophthalmology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
Purpose: To assess 12-month visual acuity, anatomic integrity, and complication rates after Boston Type I Keratoprosthesis (BKPro-I) implantation in eyes with multiple failed penetrating keratoplasties and complex anterior segment pathology. Methods: In this prospective case series, four eyes (mean age, 32 ± 9 years) received BKPro-I between January and June 2022. All surgeries employed polymethylmethacrylate front plates, customized titanium back plates, and a standardized perioperative regimen (IV cefazolin, topical vancomycin + levofloxacin, corticosteroid taper, nightly povidone-iodine, selective antifungal prophylaxis) with early 16 mm scleral lens fitting. Follow-up occurred at 3 days, 1 week, 2 weeks, monthly to 3 months, then quarterly to 12 months postoperatively. Primary outcomes were best-corrected visual acuity (BCVA), device retention, and sight-threatening complications. Results: At 12 months, all devices were retained. Functional success (BCVA ≥20/200) was achieved in 100% of eyes in 6 months; at 12 months, 75% reached ≥20/100 and 50% ≥20/60 (mean gain ≥5 ETDRS lines). Two eyes (50%) developed complications - retroprosthetic membranes, vitritis/suspected endophthalmitis, stromal melting, chronic hypotony, and silicone-oil leak - all managed without device loss; one eye's vision declined to finger counting at month 7 but remained ambulatory. Conclusions: BKPro-I yields excellent short-term visual rehabilitation and perfect retention in highly complex eyes. However, a 50% complication rate mandates rigorous patient selection, standardized perioperative protocols, and lifelong multidisciplinary follow-up.
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