Boston type 1 keratoprosthesis: the university of california davis experience.
OBJECTIVE
To compare the University of California Davis experience using the Boston keratoprosthesis with the Boston Keratoprosthesis Study Group's initial report.


METHODS
Retrospective chart review.


METHODS
We analyzed 30 eyes of 28 patients who previously underwent Boston type 1 keratoprosthesis surgery at our institution between 2004 and 2008.


METHODS
Preoperative, intraoperative, and postoperative parameters were collected and analyzed.


METHODS
Visual acuity and keratoprosthesis stability.


RESULTS
Preoperative diagnoses were failed graft (26 eyes, 87%), chemical injury (3 eyes, 10%), and Stevens-Johnson syndrome (1 eye, 3%). Twenty eyes (66%) had preoperative glaucoma. Preoperative best-corrected visual acuity ranged from 20/150 to light perception and was <20/200 in 83% of eyes. At an average follow-up of 19 months (range, 1-48; SD, 13.8; and median, 13), postoperative vision improved to >or=20/200 in 77% of eyes. Among eyes at least 1 year after the operation (16 eyes), vision was >or=20/200 in 75% of eyes and >or=20/40 in 25% of eyes. At an average follow-up of 19 months, retention of the initial keratoprosthesis was 83.3%.


CONCLUSIONS
The Boston type 1 keratoprosthesis is a viable option after multiple keratoplasty failures or in conditions with a poor prognosis for primary keratoplasty. Patients with autoimmune disease are at higher risk for complications. The University of California Davis experience seems equivalent to the initial report of the Boston Keratoprosthesis Study Group. With longer follow-up, additional surgical procedures may be required but good anatomic and functional outcomes can be maintained.
Bradley
Jay C
JC
Department of Ophthalmology & Vision Science, University of California Davis, Sacramento, CA 95817, USA.
Hernandez
Enrique Graue
EG
Schwab
Ivan R
IR
Mannis
Mark J
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001187:Artificial Organs; D002675:Child, Preschool; D003315:Cornea; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult