Influence of Primary Diagnosis and Complications on Visual Outcome in Patients Receiving a Boston Type 1 Keratoprosthesis

Abstract

Purpose: To analyse how primary diagnosis and complications affect the evolution of post-operative visual acuity (VA). Methods: We performed retrospective chart analysis on 59 eyes in 57 patients with various diagnoses, most of which were non-standard indications for Boston type 1 keratoprosthesis (Kpro) implantation. The follow-up period was at least 3 months. Patients were classified based on the evolution of post-operative VA: group A demonstrated stable VA improvement, group B lost VA improvement and group C no significant VA improvement. Results: We assigned 46% of our cases to group A with stable VA improvement, 32% to group B with lost VA improvement, and 22% to group C with no VA improvement. The number of graft failures before Kpro implantation did not influence VA outcome. Except for the relatively good VA outcome in chemical burn and radiation injury patients, there seems to be no association between primary diagnosis and positive or negative VA outcome. Only 9% of patients with posterior segment complications and 20% with infections and associated pathologies were assigned to group A. Conclusion: Most cases (78%) showed improvement in VA after Boston type 1 Kpro (groups A and B). Posterior segment complications and infections mostly resulted in persistent loss of vision. These complications should be prevented and carefully treated.

Vitreoretinal Complications in Eyes With Boston Keratoprosthesis Type I

“…8,[12][13][14][15][16][17] In our study, RPM was seen in 48% of cases with VR complications and 24% of all cases. The exact cause leading to RPM formation is not known yet, but several hypotheses have been put forth.…”

“…Posterior segment complications mostly result in persistent loss of vision, and these complications should be prevented and carefully treated. 8 In managing these cases, we have drawn from our past experience with management of eyes with BKP and the other types of permanent keratoprosthesis. 2,9,10 The mean time interval between KP implant and the occurrence of VR complication(s) in our study was 8 months.…”