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. 2023 Jan;261(1):161-170.
doi: 10.1007/s00417-022-05744-0. Epub 2022 Jul 20.

Anatomical and functional outcomes of Boston type I keratoprosthesis as primary penetrating corneal procedure in high-risk and non-high-risk cases

Víctor Lázaro-Rodríguez  1   2 , Rafael I Barraquer  3   4 , Gemma Julio  3   4 , Jennifer Bolaños  3 , Juan Álvarez de Toledo  3   4 , Maria Fideliz de la Paz  3   4
Affiliations

Anatomical and functional outcomes of Boston type I keratoprosthesis as primary penetrating corneal procedure in high-risk and non-high-risk cases

Víctor Lázaro-Rodríguez et al. Graefes Arch Clin Exp Ophthalmol. 2023 Jan.

Abstract

Purpose: To analyze the anatomical and functional results of Boston type I keratoprosthesis (B1-KPro) as a primary corneal procedure in high-risk (HR) cases and non-high-risk (NHR) cases.

Methods: In this retrospective interventional case series, all patients who underwent B1-KPro at a single center between January 2006 and March 2021 were reviewed and identified. Cases were classified according to the primary diagnosis. Anatomical failure was considered in the case of prosthesis extrusion or phthisis bulbi. Functional failure was a postoperative corrected distance visual acuity (CDVA) ≥ 1.3 LogMAR (≤ 0.05 decimal) at the end of the follow-up period.

Results: Twenty-three eyes were included for analysis. Thirteen eyes were classified as HR and 10 as NHR. The mean age was 46.5 ± 26.5 years (5-84 years) in the HR group and 49.5 ± 26.9 years (2-78 years) in the NHR group. The mean follow-up was 42.0 ± 35.9 months (1.5-118 months) in HR and 44.8 ± 38.8 months (1-107 months) in NHR. Three eyes in the HR and none in the NHR group showed anatomical failure. Functional failure was reported in 5/13 eyes in the HR and 8/10 in the NHR group. Functional cumulative survival probability was 92% and 82% for the HR group at 1 and 2 years, respectively. In the NHR group, it was 27% at both times. No significant differences were found between groups, except for functional survival in the HR group due to better visual potential of the eyes.

Conclusions: B1-KPro as a primary corneal procedure is a valid option for visual rehabilitation in high-risk cases.

Keywords: Autoimmune disease; Congenital aniridia; High risk; Ocular chemical burn; Primary Boston type I keratoprosthesis.

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