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Boston type 1 keratoprosthesis provides long-term visual acuity improvement
The Boston type 1 keratoprosthesis provided significant visual improvement in many eyes over the long term, according to a study.
The retrospective chart review of KPro implantations completed by a single surgeon at the Stein Eye Institute between May 1, 2004, and May 1, 2011, aimed to evaluate the long-term outcomes, complications and retention of the procedure. Patients’ preoperative ocular history, intraoperative data, and postoperative management and outcomes, including interval-corrected distance visual acuity (CDVA), were analyzed.
There were 74 KPros implanted in 58 eyes during that time, with more than one being implanted in 10 eyes.
Before implantation, CDVA was recorded as counting fingers or worse in 86% of eyes and 20/200 or greater in 5% of eyes. The percentage with 20/200 or greater increased to 57% at 4 years after surgery and 82% at 8 years after surgery. Final follow-up CDVA was improved in 60% of the 10 eyes that received more than one keratoprosthesis, unchanged in 20% and decreased in 20%.
The 55 eyes that retained the keratoprosthesis had a 65% rate of improvement in CDVA, with 15% unchanged and 20% decreasing.
Glaucoma was the most common cause of both failure to obtain and failure to maintain 20/200 CDVA.
There was a probability of 72.9% of having vision of 20/200 or better at 5 years postoperatively.
“The relatively stable visual outcomes and decreasing incidence of postoperative complications and retention failure over the first 10 years after KPro implantation provide encouraging results to patients, KPro surgeons and corneal surgeons who do not perform KPro surgery secondary to concerns regarding long-term outcomes,” the study authors wrote. – by Rebecca L. Forand
Disclosures: The authors report no relevant financial disclosures.