Short-Term Visual Outcomes of Boston Type 1 Keratoprosthesis Implantation

Purpose: To report the short-term visual outcomes after keratoprosthesis implantation. Design: Retrospective multi center case series (Wilmer Eye Institute and University of Rochester Eye Institute). Participants: One hundred twenty-two patients (126 eyes) with corneal diseases that were deemed ineligible to receive donor corneal transplants. Intervention: Patients underwent a Boston type I keratoprosthesis procedure for visual rehabilitation. Main Outcome Measures: 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. Results: 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. Conclusions: Boston keratoprosthesis seems to provide rapid visual recovery with excellent uncorrected acuity in the early postoperative period. Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article.