Abstract
Purpose: :
To report indications, practices, complications, and outcomes of Boston Type I Keratoprosthesis performed at Massachusetts Eye Research and Surgery Institution (MERSI).
Methods: :
Review of all patients who received Boston Type I K-Pro at MERSI between March of 2008 and October of 2009. The main outcomes assessed were visual acuity, K-Pro survival, and K-Pro induced complications.
Results: :
Twenty-four eyes received K-Pro surgery at MERSI between March of 2008 and October of 2009. Fifteen of the patients were male and nine were female. Common pre-op diagnoses include corneal dystrophies, prior failed penetrating keratoplasties, pemphigoid, herpetic keratitis and pre-phthisical eyes in hypotony. Pre-operative visual acuity was less than hand motion in 18/24 patients. Best post operative visual acuity was better then 20/60 in 14 of 24 eyes. Complications were noted in seven patients, with three patients eventually needing removal of their K-Pro. These complications included post-operative infections in three patients, development of retro-optical membranes in four patients and the development of a retinal detachment in one patient.
Conclusions: :
The Boston Type I Keratoprosthesis offers significant visual benefit in patients who would ordinarily not be candidates for penetrating keratoplasty. It should be considered, however, "high risk" surgery, with risk of failure to accomplish the goal of improved vision the highest of the possible risks.
Keywords: keratoprostheses • autoimmune disease • anterior segment