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R. J. Peralta, A. J. Kanellopolous; Boston Keratoprosthesis : A Long-Term Prospective Clinical Study. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1895. doi: https://doi.org/.
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To evaluate the safety, efficacy and long term complications of the Boston Keratoprosthesis artificial cornea procedure in 25 cases of severe external disease and/or repeat graft failure.
25 cases of 20 patients were evaluated for uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), corneal clarity, and complications 14 to 114 months (mean 38 months) post-transplantation.
Preoperative diagnoses and (number of cases) included ocular cicatricial pemphigoid (OCP, 11), repeat graft failure (8) and ocular burn (6). At 12 months post-transplantation, all keratoprostheses remained clear and UCVA had improved from 0.05 (0.01 to 0.1) to 0.2 (0.05 to 1). Subsequently, 23 of 25 remained clear at 24 months, 15 of 19 at 36 months and 11 of 16 at 48 months. Severe post-transplantation complications included keratoprosthesis-related corneal melt (8), endophthalmitis (4), macular disease (pucker, exudative AMD; 3), retinal detachment (2) and extrusion (2). 5 cases required retransplantation once, and 1 case required retransplantation twice.
The Boston Keratoprosthesis offers a significant visual rehabilitation option for patients with severe ocular surface disease. The safety and efficacy must be regarded with the severity of eye disease, alternate options for visual rehabilitation and requirements for pragmatic functionality. Severe post-operative complications are not uncommon, but may be managed effectively with close observation and preventive measures.
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