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Newer Boston KPro design reduces tissue necrosis rates, study finds
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The newer version of the Boston Keratoprosthesis, which features small holes in its back plate to allow more nutrition to reach the carrier graft, is associated with a lower incidence of tissue melts compared with the older prosthesis model, a retrospective study found.
Mona Harissi-Dagher, MD, and colleagues reviewed the frequency of tissue melt among 157 eyes implanted with one of the two versions of the Boston KPro device; 79 eyes had received the newer model, which features eight 1.3-mm diameter holes in its back plate, and 78 eyes received the older design featuring a solid back plate.
Overall, 48 eyes (31%) had developed some degree of tissue melt around the stem. This included eight of the 79 eyes (10%) that received the perforated Boston KPro model and 40 of the 78 eyes (51%) that received the solid back plate model (P < .0001), according to the study.
Four of the eight eyes that experienced melts in the perforated back plate group had an underlying autoimmune disease, such as Stevens-Johnson syndrome or ocular cicatricial pemphigoid, the authors noted.
"The Boston KPro design with a back plate containing holes protects the overlying corneal tissue from necrosis and melts. This improved situation is likely due to increased aqueous access and better nutrition to the corneal graft cells," the study authors said.
"In addition, this study confirms earlier work regarding the particular corneal fragility of patients with autoimmune diseases," they said.
The study is published in the June issue of Cornea.