Short-Term Visual Outcomes of Boston Type 1 Keratoprosthesis Implantation

Abstract

To report the short-term visual outcomes after keratoprosthesis implantation. Retrospective multi center case series (Wilmer Eye Institute and University of Rochester Eye Institute). One hundred twenty-two patients (126 eyes) with corneal diseases that were deemed ineligible to receive donor corneal transplants. Patients underwent a Boston type I keratoprosthesis procedure for visual rehabilitation. The medical records of the patients were reviewed to assess intraoperative and postoperative complications, uncorrected and best-corrected visual acuity, as well as the degree of refractive error at various time points. One hundred four patients (82.5%) achieved improved vision within 6 months after surgery. An overwhelming majority of those patients who had improved vision had a manifest refraction of plano. The mean spherical refractive error was -0.57 diopters (D) and mean astigmatism was 0.10 D. Cumulatively, 7.1% patients achieved their best-corrected vision at 1 day, 24.6% at 1 week, and 70.6% at 3 months. The patients who achieved their best-corrected visual acuity after the first 3-month period most often were the ones who required multiple surgeries owing to preexisting or postoperative complications. Boston keratoprosthesis seems to provide rapid visual recovery with excellent uncorrected acuity in the early postoperative period. The authors have no proprietary or commercial interest in any of the materials discussed in this article.