Boston keratoprosthesis type 1 device leak

Abstract

ObjectiveTo report a leak at the cornea–anterior front plate interface of the Boston keratoprosthesis type 1 (KPro) leading to hypotony. DesignRetrospective interventional case series. ParticipantsThree patients (3 eyes) who experienced development of hypotony after Boston KPro type 1 implantation surgery at the Centre Hospitalier de l’Université de Montréal. MethodsMedical records of the 3 patients at our institution were reviewed with regard to preoperative and postoperative best corrected visual acuity (BCVA), digital intraocular pressure (IOP), time to diagnosis of hypotony, related complications, and the need for medical and surgical treatment. ResultsPre-KPro BCVA ranged from counting fingers to light perception and improved to a mean of 20/100 in the operated eye. The incidence rate of leaks after KPro type 1 implantation was 2.7% (3 patients). The hypotony was noted at a mean of 13.7 months postoperatively. All patients had uveitis and vitritis preceding choroidal and retinal detachments, and required vitreoretinal surgeries for repair. In all patients, an objective leak through the cornea–anterior front plate interface of the KPro was seen intraoperatively by the vitreoretinal surgeon. Mean BCVA in these patients stabilized at 20/300 after the complication resolved, with a mean IOP of 10 mm Hg. ConclusionsLeak next to the KPro stem can occur after several months and can lead to significant visual loss. Prompt recognition and team management of this complication are required.