Outcomes of Boston Keratoprosthesis as Primary Penetrating Corneal Procedure
Narrative Responses:
Purpose
To evaluate the efficacy and safety of Boston type 1 keratoprosthesis (KPro) surgery as a primary penetrating corneal surgery for patients with corneal blindness and poor prognosis for traditional penetrating keratoplasty (PK).
Methods
A chart review of all patients who underwent KPro implantation by a single surgeon (MHD) between October 2008 and March 2011 at the Centre Hospitalier de l'Université de Montréal was performed. Patients with KPro as a primary procedure (Group 1) were compared to patients who had PK prior to KPro implantation (Group 2). Preoperative and postoperative best-corrected visual acuity (BCVA), intraoperative and postoperative complications, and KPro retention were examined.
Results
Of the seventy eyes (63 patients) included in this study, thirty eyes (26 patients) had KPro as a primary corneal surgery. There was no difference in baseline preoperative characteristics between the two treatment groups. No intraoperative complications were encountered. At 3, 6 and 12 months, BCVA was statistically significantly better in group 1 (P < 0.05). The complication rates were not significantly different between the two groups after one-year follow-up. Retention rate was similar in the two groups: 100% in Group 1 and 97.5% in Group 2 (P> 1.00).
Conclusion
Boston KPro implantation can be successful as a primary procedure in patients with a high risk of failure with traditional PK. Further prospective studies are needed to validate the efficacy and safety results.