Long-term results of Boston keratoprosthesis surgery in Polish patients

Abstract

Abstract Introduction To evaluate the long-term (10 year) outcomes of Boston type 1 keratoprosthesis (BKPro; Massachusetts Eye and Ear Infirmary, Boston, MA) surgery performed in 6 Polish patients. Materials and Methods 6 eyes of 6 patients (1 female and 5 males; mean age 49,5±6,34 years) were qualified for the surgery. Indications for BKPro surgery in the study group included: corneal graft failure (3 patients), chemical ocular burns (2 patients), and post-herpetic keratitis vascularized leucoma (1 patient). Visual acuity, slit-lamp examination with ocular surface assessment, anterior segment optical coherence tomography (AS OCT), fundoscopy, and intraocular digital pressure measurement were performed at each visit. Results Retention of keratoprosthesis was achieved in all patients during the follow-up period. At last recorded visits VA≥0,2 was observed in 3 patients, LP in one patient and NLP in 2 patients. The complications which occurred in our case series were: glaucoma (4 patients preoperatively, 6 patients postoperatively), retroprosthetic membrane formation (1 patient), epimacular membrane formation (2 patients) and severe Meibomian Gland Dysfunction (3 patients). OCT analysis allowed imaging of anterior iris synechiae, AGV tube, protrusion of the BKPro and retroprosthetic membrane not visible on the slit lamp examination. Conclusions BKPro surgery should be considered as a surgery of choice in patients who have high risk of PK failure. OCT plays a role in anterior eye segment monitoring and detection of complications not visible on the slit lamp examination in the follow up period. Implementing the dry eye disease treatment should be recommended in all patients undergoing BKPro surgery.