Abstract
Purpose: :
To describe outcomes after Boston Keratoprosthesis Type 1 (KPro) surgery in aniridic eyes.
Methods: :
A retrospective chart review of 21 aniridic eyes (15 patients) that underwent KPro implantation by a single surgeon (MHD) between October 2008 and April 2011 in a university center was performed. Preoperative and postoperative best-corrected visual acuity (BCVA), intraoperative and postoperative complications, and keratoprosthesis retention were examined.
Results: :
Mean age was 54.3 years (range, 27-71); 8 patients were male. Six patients had bilateral procedures. No intraoperative complications were encountered. Preoperatively, BCVA was 20/200 or worse in all eyes. After a mean follow-up time of 20.9 months (range, 4.2-36.2), the most recent BCVA ranged from 20/70 to no light perception. Visual potential was limited by pre-existing terminal glaucoma (n=2), phthisis after retinal detachment (n=2), and suprachoroidal hemorrhage (n=2). Other postoperative complications included retroprosthetic membrane formation (n=11), trans-prosthetic leakage (n=2), and extrusion (n=1). Uncomplicated uveitis was reported in 6 eyes. No endophthalmitis or corneal melt occurred in this series. The majority of eyes have glaucoma and are on medical treatment.
Conclusions: :
The prognosis in aniridic patients after KPro is variable, but is favorable overall. Meticulous follow-up and a subspecialty team approach are important.
Keywords: keratoprostheses