May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Boston Keratoprosthesis Outcomes and Complications
Author Affiliations & Notes
  • H. F. Chew
    Wills Eye Institute, Philadelphia, Pennsylvania
    Cornea,
  • B. D. Ayres
    Wills Eye Institute, Philadelphia, Pennsylvania
    Cornea,
  • K. M. Hammersmith
    Wills Eye Institute, Philadelphia, Pennsylvania
    Cornea,
  • C. J. Rapuano
    Wills Eye Institute, Philadelphia, Pennsylvania
    Cornea,
  • P. R. Laibson
    Wills Eye Institute, Philadelphia, Pennsylvania
    Cornea,
  • J. S. Myers
    Wills Eye Institute, Philadelphia, Pennsylvania
    Glaucoma Service,
  • E. J. Cohen
    Wills Eye Institute, Philadelphia, Pennsylvania
    Cornea,
  • Footnotes
    Commercial Relationships  H.F. Chew, None; B.D. Ayres, None; K.M. Hammersmith, None; C.J. Rapuano, None; P.R. Laibson, None; J.S. Myers, None; E.J. Cohen, None.
  • Footnotes
    Support  Dr. Chew received an E.A. Baker Fellowship Fund grant from the Canadian National Institute for the Blind.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 5708. doi:https://doi.org/
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      H. F. Chew, B. D. Ayres, K. M. Hammersmith, C. J. Rapuano, P. R. Laibson, J. S. Myers, E. J. Cohen; Boston Keratoprosthesis Outcomes and Complications. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5708. doi: https://doi.org/.

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

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Abstract

Purpose: : To evaluate the clinical outcomes of the Boston Keratoprosthesis at our institution.

Methods: : A retrospective study was performed. Thirty-six patients received a Boston Keratoprosthesis from August 2005 to October 2007. Outcome measures included device retention rate, pre-operative and post-operative best corrected visual acuities (BCVA), and post-operative complications.

Results: : The mean age of all patients was 67.5 years (median 71, range: 24-93). Mean time of follow-up was 12.1 months. Twenty-three patients were male. The primary indication for the Boston Keratoprosthesis was failed penetrating keratoplasty in 28 patients--21 from multiple failed penetrating keratoplasties. Pre-operative comorbidities included glaucoma (26 patients) and limbal stem cell deficiency (10 patients). The main post-operative complications included: retroprosthetic membrane or posterior capsular opacification (22 patients), glaucoma progression (5 patients), corneal melting (4 patients) and endophthalmitis (4 patients). At last follow-up, 35 Keratoprostheses were retained--a Type II through-the-lid Keratoprosthesis extruded and was replaced. The median pre-operative BCVA was hand motions (range: light perception to 20/100). The median BCVA on last follow-up was 20/60 (range: light perception to 20/25). On last follow-up, the BCVA improved in 33 patients, two patients had no improvement, while one had worse vision.

Conclusions: : Complications following Keratoprosthesis occur and require careful, frequent follow-up to monitor and treat glaucoma progression, endophthalmitis and inflammation. Despite these potential complications, the Boston Keratoprosthesis provides visual improvement in a patient population with an otherwise poor prognosis.

Keywords: keratoprostheses 
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