The Boston keratoprosthesis in herpetic keratitis.
OBJECTIVE
To evaluate the role of an artificial cornea (Boston Keratoprosthesis [KPro]) in herpetic corneal graft failures.


METHODS
A series of 17 herpetic eyes of 14 patients with failed transplantations, treated with implantation of a corneal graft with a KPro, was reviewed. Outcomes measured were retention of the device, visual acuity at 1 week, best visual acuity, last assessed visual acuity, time of follow-up, and complications.


RESULTS
Follow-up ranged between 6 and 72 months (median, 14 months). All patients had improvement in postoperative visual acuity, with 16 (94%) of 17 eyes getting better than preoperative visual acuity within 1 week. Of the 17 eyes, 15 (88%) achieved a best visual acuity of 20/25 to 20/70 and, at the last examination, 11 eyes (73%) were still in that range. Four patients with prolonged preoperative inflammation and ulceration at KPro placement had resolution of inflammation within days. The KPro had no extrusions. Complications included retroprosthesis membrane in 3 eyes and 1 tissue melt in an early case.


CONCLUSIONS
The KPro can be of value in patients with graft failure from herpetic keratitis, even in the inflamed stage. We believe that herpetic keratitis is not a contraindication for KPro use.
Khan
Bilal F
BF
Department of Cornea and Refractive Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
Harissi-Dagher
Mona
M
Pavan-Langston
Deborah
D
Aquavella
James V
JV
Dohlman
Claes H
CH
D000368:Aged; D000369:Aged, 80 and over; D001187:Artificial Organs; D003315:Cornea; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D016849:Keratitis, Herpetic / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology
D019904:Polymethyl Methacrylate