Boston Type 1 Keratoprosthesis: Visual Outcomes, Device Retention, and Complications

Kenneth M Goins; Anna S Kitzmann; Mark A Greiner; Young H Kwon; Wallace L M Alward; Johannes Ledolter; Michael D Wagoner

doi:10.1097/ICO.0000000000000886

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Boston Type 1 Keratoprosthesis: Visual Outcomes, Device Retention, and Complications

Journal article

Peer reviewed

Boston Type 1 Keratoprosthesis: Visual Outcomes, Device Retention, and Complications

Kenneth M Goins, Anna S Kitzmann, Mark A Greiner, Young H Kwon, Wallace L M Alward, Johannes Ledolter and Michael D Wagoner

Cornea, Vol.35(9), pp.1165-1174

09/2016

DOI: 10.1097/ICO.0000000000000886

PMID: 27191675

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Abstract

To determine the visual outcomes, device retention, and complications after Boston type 1 keratoprosthesis (KPro-1) device implantation. Comprehensive review of every case of KPro-1 implantation at a tertiary eye care center. The initial KPro-1 procedure, performed in 75 eyes without a previous keratoprosthesis, was included in the analysis. During the first 6 postoperative months, improvement occurred in the mean preoperative best-corrected visual acuity of 20/1265 to a mean best-obtained postoperative visual acuity of 20/97 (P < 0.001). After a mean follow-up period of 41.4 months (range, 0.8-82.8 months), the final mean best-corrected visual acuity was 20/428. Improved vision was recorded in 43 eyes (57.3%), ambulatory vision (≥20/400) in 47 eyes (62.7%), intermediate functional vision (≥20/80) in 23 eyes (30.7%), and full functional vision (≥20/40) in 11 eyes (14.7%). The initial device was retained in 64 eyes (85.3%), with a Kaplan-Meier retention probability of 96% at 6 months and 82% at 5 years. One or more sight-threatening complications occurred in 51 eyes (68%). These included device extrusion in 11 eyes (14.7%), ulcerative keratitis in 12 eyes (16%), endophthalmitis in 7 eyes (9.3%), sterile vitritis in 3 eyes (4%), retroprosthetic membranes in 25 eyes (33.3%), maculopathy in 26 eyes (34.7%), retinal detachment in 9 eyes (12%), and progressive optic neuropathy in 7 eyes (9.3%). Boston KPro-1 implantation is associated with satisfactory visual outcomes and excellent device retention in a majority of cases. However, serious postoperative complications are common and may compromise the final visual result.

Prostheses and Implants

Artificial Organs

Cornea

Prosthesis Implantation

Follow-Up Studies

Humans

Middle Aged

Child, Preschool

Bioprosthesis

Infant

Male

Corneal Diseases - surgery

Adolescent

Aged, 80 and over

Graft Survival - physiology

Adult

Female

Aged

Retrospective Studies

Child

Postoperative Complications

Visual Acuity - physiology

Details

Title: Subtitle: Boston Type 1 Keratoprosthesis: Visual Outcomes, Device Retention, and Complications
Creators: Kenneth M Goins - University of Iowa, Ophthalmology and Visual Sciences
Anna S Kitzmann - University of Iowa
Mark A Greiner - University of Iowa, Ophthalmology and Visual Sciences
Young H Kwon - University of Iowa, Ophthalmology and Visual Sciences
Wallace L M Alward - University of Iowa, Ophthalmology and Visual Sciences
Johannes Ledolter - University of Iowa, Tippie College of Business
Michael D Wagoner - University of Iowa, Ophthalmology and Visual Sciences
Resource Type: Journal article
Publication Details: Cornea, Vol.35(9), pp.1165-1174
Publisher: United States
DOI: 10.1097/ICO.0000000000000886
PMID: 27191675
ISSN: 0277-3740
eISSN: 1536-4798
Language: English
Date published: 09/2016
Academic Unit: Statistics and Actuarial Science; Business Analytics; Ophthalmology and Visual Sciences
Record Identifier: 9983980069802771

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