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J. B. Ciolino, J. W. Ament, B. L. Zerbe, M. W. Belin; Etiology of Keratoprosthesis Loss: Results From the Boston Keratoprosthesis Multicenter Study. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5712.
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© ARVO (1962-2015); The Authors (2016-present)
To report causes of failure to retain the Boston Type 1 Keratoprothesis
Pre-operative and post-operative data was collected and analyzed from the Boston Keratoprosthesis Multicenter Study Group (22 surgeons).
21 of 252 implanted keratoprosthesis were not retained. Overall the retention rate was 91.6% (average follow-up of 13 months, range 1 - 53 months).25.6% (11/ 43) of patients with autoimmune disease failed to retain the KPro. 9 of the autoimmune KPro’s lost developed a cornea melt around the implant requiring its replacement.10.7% (3/ 28) KPro’s with a history of chemical injury required replacement. 2 due to thinning of the peripheral donor cornea at the donor-host interface.Only 3.8% (7/ 181) of the remaining KPro’s were not retained. 3 of the eyes were enucleated after large retinal detachments, 2 were replaced due to fungal keratitis, and 2 experienced a corneal melt around the implant.
Patients with autoimmune disease have the poorest KPro retention mostly due to cornea melting around the implant. Patients with chemical injuries also have a guarded prognosis and appear to be at a higher risk of thinning of the peripheral donor cornea. Patients lacking chemical injury or autoimmune disease have an excellent retention rate (96%).
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