June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Boston type 1 keratoprosthesis: surgical indications, short term retention and achievement of 20/200 vision
Author Affiliations & Notes
  • Kristine Lo
    Massachusetts Eye and Ear Infirmary, Boston, MA
  • Kathryn Colby
    Massachusetts Eye and Ear Infirmary, Boston, MA
  • James Chodosh
    Massachusetts Eye and Ear Infirmary, Boston, MA
  • Footnotes
    Commercial Relationships Kristine Lo, None; Kathryn Colby, Novartis (S); James Chodosh, Alcon (C), Allergan (C), 3-V Biosciences (C), Novabay (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3459. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Kristine Lo, Kathryn Colby, James Chodosh; Boston type 1 keratoprosthesis: surgical indications, short term retention and achievement of 20/200 vision. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3459.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose: The Boston type 1 keratoprosthesis (KPro) is the most commonly used keratoprosthesis in the US and the world,with more than 7,000 implantations to date. A high proportion of candidates for this device are elderly. The objectives of this study are to identify surgical indications,device retention rate at the 3 month postoperative period and the proportion of patients that achieved at least 20/200 vision,which is normally considered the threshold for safe ambulation,in order to predict device “success” for patients later in life who are less likely to experience late complications.

Methods: The charts of patients who underwent keratoprosthesis surgery at Massachusetts Eye and Ear Infirmary between January to December 2011 were retrospectively reviewed.

Results: The type 1 KPro was implanted in 28 patients for the first time during the year 2011. Of these 28 patients, 27 had at least 3 months of follow-up data and were included in the analysis. The patients’ age ranged from 37 to 86 years of age with an average of 64.8. 15 (55.5%) patients were over the age of 65. Indications for surgery included failed grafts(66.7%),corneal opacity(14.8%),bullous keratopathy(7.4%),aniridia(3.7%),Stevens Johnson Syndrome(3.7%),and pemphigoid(3.7%). The majority (70.4%) of these patients had prior traditional corneal transplants, but a minority (29.6%) received it as a primary procedure. Of the 27 patients analyzed, 18 (66.7%) achieved at least 20/200 vision within the 3 month postoperative period. Of the 9 patients who did not achieve a postoperative vision of at least 20/200, 8 had preexisting severe retinal disease or glaucoma, which limited visual prognosis. Only 1 of the 9 patients with potential for at least 20/200 vision failed to achieve it, due to a dense retroprosthetic membrane. Of those 15 patients over the age of 65, 10 (66.7%) achieved at least 20/200 vision within the 3 month postoperative period. 100% of the 27 patients retained the keratoprosthesis at the 3 month postoperative period.

Conclusions: Our study demonstrates excellent short term device retention. A majority of the patients achieved at least 20/200 vision within the 3 month postoperative period. The Boston type 1 keratoprosthesis remains a viable option for salvaging vision in older patients with corneal disease in which traditional keratoplasty would carry a poor prognosis.

Keywords: 575 keratoprostheses  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×