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Boston type 1 keratoprosthesis: the New York Eye and Ear experience.
Eye (Lond) 2012; 26(3):418-25E

Abstract

PURPOSE

The Boston keratoprosthesis has had variable success rates in the past. However, significant modifications to design and management have recently led to successful outcomes. This study was undertaken to evaluate the outcomes of the Boston type 1 keratoprosthesis at our institution.

METHODS

A retrospective chart review was performed of all Boston type 1 keratoprosthesis procedures conducted at a single practice at the New York Eye and Ear Infirmary from December 2006 to August 2010. Outcome measures included visual acuity, retention rates, and complications.

RESULTS

In all, 58 eyes of 51 patients who received a Boston type 1 keratoprosthesis were included. The most common indication for the keratoprosthesis was failed penetrating keratoplasty (PK) (81.0%; mean 2.4±1.3 PKs per eye). Glaucoma was the most common comorbidity (75.9%). Pre-operative best corrected visual acuity (BCVA) was <20/400 in 87.9% of eyes. At last follow-up, 43.1% of eyes had a BCVA of 20/200. Retention rate was 87.9% over an average follow-up of 21.5±11.4 months (median 22 months, range 3-47 months). Complications increased with time, with 65.5% of eyes experiencing at least one event by 6 months and 75.9% by 1 year. The most common post-operative complication was retroprosthetic membrane formation (50.0%).

CONCLUSIONS

The Boston type 1 keratoprosthesis provides visual recovery for eyes with multiple PK failures or with poor prognosis for primary PK, showing excellent retention rates. However, there is a trend towards a decline in visual acuity with time and the development of late complications, highlighting a need for longer-term studies.

Authors+Show Affiliations

Department of Ophthalmology, The New York Eye and Ear Infirmary, New York, NY, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22173079

Citation

Patel, A P., et al. "Boston Type 1 Keratoprosthesis: the New York Eye and Ear Experience." Eye (London, England), vol. 26, no. 3, 2012, pp. 418-25.
Patel AP, Wu EI, Ritterband DC, et al. Boston type 1 keratoprosthesis: the New York Eye and Ear experience. Eye (Lond). 2012;26(3):418-25.
Patel, A. P., Wu, E. I., Ritterband, D. C., & Seedor, J. A. (2012). Boston type 1 keratoprosthesis: the New York Eye and Ear experience. Eye (London, England), 26(3), pp. 418-25. doi:10.1038/eye.2011.325.
Patel AP, et al. Boston Type 1 Keratoprosthesis: the New York Eye and Ear Experience. Eye (Lond). 2012;26(3):418-25. PubMed PMID: 22173079.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Boston type 1 keratoprosthesis: the New York Eye and Ear experience. AU - Patel,A P, AU - Wu,E I, AU - Ritterband,D C, AU - Seedor,J A, Y1 - 2011/12/16/ PY - 2011/12/17/entrez PY - 2011/12/17/pubmed PY - 2012/5/4/medline SP - 418 EP - 25 JF - Eye (London, England) JO - Eye (Lond) VL - 26 IS - 3 N2 - PURPOSE: The Boston keratoprosthesis has had variable success rates in the past. However, significant modifications to design and management have recently led to successful outcomes. This study was undertaken to evaluate the outcomes of the Boston type 1 keratoprosthesis at our institution. METHODS: A retrospective chart review was performed of all Boston type 1 keratoprosthesis procedures conducted at a single practice at the New York Eye and Ear Infirmary from December 2006 to August 2010. Outcome measures included visual acuity, retention rates, and complications. RESULTS: In all, 58 eyes of 51 patients who received a Boston type 1 keratoprosthesis were included. The most common indication for the keratoprosthesis was failed penetrating keratoplasty (PK) (81.0%; mean 2.4±1.3 PKs per eye). Glaucoma was the most common comorbidity (75.9%). Pre-operative best corrected visual acuity (BCVA) was <20/400 in 87.9% of eyes. At last follow-up, 43.1% of eyes had a BCVA of 20/200. Retention rate was 87.9% over an average follow-up of 21.5±11.4 months (median 22 months, range 3-47 months). Complications increased with time, with 65.5% of eyes experiencing at least one event by 6 months and 75.9% by 1 year. The most common post-operative complication was retroprosthetic membrane formation (50.0%). CONCLUSIONS: The Boston type 1 keratoprosthesis provides visual recovery for eyes with multiple PK failures or with poor prognosis for primary PK, showing excellent retention rates. However, there is a trend towards a decline in visual acuity with time and the development of late complications, highlighting a need for longer-term studies. SN - 1476-5454 UR - https://www.unboundmedicine.com/medline/citation/22173079/Boston_type_1_keratoprosthesis:_the_New_York_Eye_and_Ear_experience_ L2 - http://dx.doi.org/10.1038/eye.2011.325 DB - PRIME DP - Unbound Medicine ER -