Post-operative outcomes associated with Boston type 1 keratoprosthesis implantation in Northeast China

Abstract

The aim of the present study was to investigate the post-operative outcomes associated with Boston type 1 keratoprosthesis (Kpro-1) implantation in the treatment of patients with corneal blindness in Northeast China. Clinical data of patients who had undergone Kpro-1 implantation between July 2010 and November 2014 were retrospectively collected. The visual performance, implant retention and post-surgical complications were recorded for each patient. A total of 20 patients (20 eyes) with corneal blindness were included in the study. Prior to surgery, the patients exhibited poor vision and decreased levels of light perception. At 3 days, 1 month, 6 months, 1 year and 2 years post-surgery, logarithm of the minimum angle of resolution values were significantly decreased compared with the pre-operative values. The initial Kpro-1 implants were retained in 16 eyes. Regarding the post-operative complications, six patients exhibited retroprosthetic membrane formation, two patients presented with endophthalmitis, two patients developed secondary glaucoma, two patients experienced optical cylinder detachment, two patients presented with corneal melting, three patients had retinal detachment, three patients developed corneal ulcers and one patient had secondary optic neuropathy. Overall, the results of the present study suggested that implantation with Kpro-1 may represent an alternative therapeutic strategy for patients following previously failed keratoplasty in Northeast China. Serious complications associated with Kpro-1 implantation are common, and thus, suitable patient selection, continuous follow-up and early treatment interventions are recommended.

Keywords: Boston type 1 keratoprosthesis; corneal blindness; penetrating keratoplasty; visual acuity.

Figure 1.

Corneal images from one patient with corneal blindness. (A) Prior to surgery, and at (B) 1 month and (C) 1 year post-implantation with a Boston type 1 keratoprosthesis. (D) Fluorescein staining at 2 years post-surgery revealed that there was no significant staining in the conjunctiva.

Figure 2.

Visual acuity of the patients over a 2-year follow-up period. *P<0.05 vs. Pre. LogMAR, logarithm of the minimum angle of resolution; Pre, pre-surgery; Post, post-surgery.

Figure 3.

At 1 year post-implantation with Boston type 1 keratoprosthesis, the swept-source optical coherence tomography image of the anterior segment of one patient demonstrated that the corneal epithelium and the complex were fully healed.