Outcomes of Type 1 Boston Keratoprosthesis at the University of Toronto Health Network

Goldich, Yakov

Outcomes of Type 1 Boston Keratoprosthesis at the University of Toronto Health Network

Friday, April 25, 2014

KIOSKS (Boston Convention and Exhibition Center)

Yakov Goldich, MD, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada

Christopher W. Noel, University of Toronto, Toronto, ON, Canada

Jordan Isenberg, MSc, McGill University, montreal, QC, Canada

Clara C. Chan, MD, FRCSC, University of Toronto, Toronto, ON, Canada

Tessa A. Weinberg, RCSI, Toronto, ON, Canada

Jackie Slomovic, York University, Toronto, ON, Canada

David S. Rootman, MD, FRCSC, University of Toronto, Toronto, ON, Canada

Allan R. Slomovic, MD, FRCSC, University Health Network, Toronto, Ontario, Canada

Narrative Responses:

Purpose
To report the outcomes of the Boston Type 1 Keratoprosthesis (KPro) at the University Health Network in Toronto, Canada.

Methods
A retrospective review was conducted of all keratoprosthesis procedures performed between June 2008 and June 2013. Thirty patients (31 eyes) were included in this study. Data regarding the preoperative characteristics and intra/postoperative course of each patient was analysed.

In 21 eyes (68%), the primary indication for a KPro was failed corneal transplantation. The remaining ten eyes (32%) had a KPro as a primary procedure

Results
In all eyes, preoperative visual acuity (VA) was ≤20/200, with 27 eyes (88%) having a VA of counting fingers, hand movement or light perception. A history of glaucoma was documented in 42% of eyes. Mean follow up time was 19±14 months (range 2-57). The retention rate at last follow up was 97%. Best-achieved median visual acuity was 20/150 (range 20/25-NLP) with 35% of patients achieving a VA of >20/40 at some point during their postoperative course. At last follow up, median VA was 20/400 (range 20/40-NLP). The two most common complications included retroprosthetic membrane formation (15,48%) and elevated IOP (10,32%).

Conclusion
Our study demonstrates that the Boston Type 1 Keratoprosthesis improves visual acuity in the majority of patients and is a viable option after multiple failed grafts or in situations where there is a poor prognosis for traditional penetrating keratoplasty.