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Review
. 2021 Jul 1;32(4):385-388.
doi: 10.1097/ICU.0000000000000774.

Challenges in management of the Boston Keratoprosthesis Type 1

Ellen H Koo  1 , Sadeer B Hannush  2
Affiliations
Review

Challenges in management of the Boston Keratoprosthesis Type 1

Ellen H Koo et al. Curr Opin Ophthalmol. .

Abstract

Purpose of review: The Boston Keratoprosthesis Type 1 was pioneered by Claes Dohlman several decades ago. Since its inception, the device has undergone multiple revisions to address challenges associated with retroprosthetic membrane formation, retention, extrusion, stromal melt and endophthalmitis. Although visual outcomes and retention rates have improved, challenges, especially glaucoma, remain.

Recent findings: The Boston Keratoprosthesis Type I device has seen an increase in popularity because of the improvement in rates of retention and visual rehabilitation. Recent outcome studies have allowed clinicians to identify diagnoses and indications that can lead to more favorable results with the Boston Keratoprosthesis Type I device.

Summary: The Boston Keratoprosthesis Type I device continues to play a vital role in visual rehabilitation for eyes with very low chance of realistic allograft survival -- such as in eyes where corneal grafting is considered high-risk: eyes with corneal limbal stem cell failure, extensive deep corneal stromal neovascularization, and multiple allograft failures. This review article summarizes the perioperative and postoperative challenges, as well as other considerations associated with the device.

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References

    1. Ciolino JB, Belin MW, Todani A, et al. Boston Keratoprosthesis Type 1 Study Group. Retention of the Boston keratoprosthesis type 1: multicenter study results. Ophthalmology 2013; 120:1195–1200.
    1. Zerbe BL, Belin MW, Ciolino JB. Boston Type 1 Keratoprosthesis Study Group. Results from the multicenter Boston Type 1 Keratoprosthesis Study. Ophthalmology 2006; 113:1779.e1–1784.e7.
    1. Lam FC, Liu C. The future of keratoprostheses. Br J Ophthalmol 2011; 95:304–305.
    1. Ahmad S, Mathews PM, Lindsley K, et al. Boston type 1 keratoprosthesis versus repeat donor keratoplasty for corneal graft failure: a systematic review and meta-analysis. Ophthalmology 2016; 123:165–177.
    1. Chhadva P, Cortina MS. Long-term outcomes of permanent keratoprosthesis. Curr Opin Ophthalmol 2019; 30:243–248.