Purchase this article with an account.
D. R. Goldman, A. Chiang, A. Y. Hu, A. J. Aldave, S. D. Schwartz, J. P. Hubschman; Postoperative Posterior Segment Complications of the Boston Type I Keratoprosthesis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2563.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The Boston type I keratoprosthesis is a growing tool for the treatment of corneal blindness in patients who would otherwise have no alternative. With this expanding scope, more scrutiny should be placed on the potential for post-operative complications. Our study characterizes and describes the posterior segment complications encountered after Boston type I keratoprosthesis implantation and their impact on visual outcomes.
A retrospective chart review was conducted of all consecutive Boston type I keratoprosthesis implants placed by a single surgeon at a single institution over a four year period. A post-operative posterior segment complication was defined as any pathology located in the posterior segment of an eye that was not present prior to keratoprosthesis implantation.
57 Boston type I keratoprosthesis impants met our inclusion criteria. Median duration of follow-up for all eyes was 16 months (range 1-54). The majority of eyes had no pre-existing significant posterior segment disease prior to keratoprosthesis implantation (82%). 37 (65%) eyes experienced at least one post-operative posterior segment complication. The most common post-operative posterior segment complications were retroprosthetic membrane (n = 22), choroidal detachment (n = 12), cystoid macular edema (n = 9), sterile vitritis (n = 8), vitreous hemorrhage (n = 6), epiretinal membrane (n = 4), and serous retinal detachment (n = 4). In eyes with significant pre-existing posterior segment disease, posterior segment complications occurred at a mean of 2.5 ± 2.3 per eye compared to a mean of 1.3 ± 1.4 per eye in eyes without pre-existing posterior segment disease (p = 0.065). In comparing eyes that did not develop post-operative posterior segment complications to eyes that did develop post-operative posterior segment complications, the mean LogMAR best-corrected visual acuity at last followup was 0.78 ± 0.71 compared to 1.19 ± 0.80 (p = 0.034) respectively.
We describe and characterize posterior segment complications encountered after Boston type I keratoprosthesis placement. There was a trend towards post-operative posterior segment complications occurring at a higher rate in eyes with pre-existing significant posterior segment disease. Final best-corrected visual acuity outcomes of eyes that did not develop post-operative posterior segment complications were better compared to eyes that did develop post-operative posterior segment complications.
This PDF is available to Subscribers Only