title: Boston type 1 keratoprosthesis for chemical and thermal injury.
abstract: OBJECTIVE
  To evaluate the outcome of the Boston type 1 keratoprosthesis (Kpro-1) in eyes with failed interventions for chemical and thermal injury.
  
  
  METHODS
  A retrospective review was performed of every eye with chemical or thermal injury that was treated with a Kpro-1 at a tertiary eye care center between January 1, 2008 and July 1, 2013. The main outcome measures were visual outcome, prosthesis retention, and postoperative complications.
  
  
  RESULTS
  Nine eyes met the inclusion criteria, including 7 eyes with alkali burns, 1 eye with an acid burn, and 1 eye with a thermal burn. After a mean follow-up of 40.7 months (range, 29-60 months), the median best-corrected visual acuity was 20/60 (range, 20/15 to no light perception). One eye was ≥20/20, 3 eyes were ≥20/40, and 6 eyes were ≥20/70. The initial Kpro-1 prosthesis was retained in 7 (77.7%) eyes and successfully replaced in the other 2 eyes. One or more serious complications occurred in 6 (66.7%) eyes. These included 2 cases of sterile corneal ulceration with prosthesis extrusion, 2 cases of microbial keratitis (1 bacterial and 1 fungal), 2 cases of bacterial endophthalmitis, and 2 cases of retinal detachments. These complications contributed to visual outcomes of hand motions in 2 eyes and no light perception in 1 eye.
  
  
  CONCLUSIONS
  The Boston Kpro-1 is associated with highly satisfactory visual outcomes and prosthesis retention in most cases of severe chemical or thermal injury. Serious complications are common and may compromise the final outcome.
authors: *Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA; and †Department of Ophthalmology, Dean McGee Eye Institute, University of Oklahoma, Oklahoma City, OK.
authors: David L
authors: DL
authors: Phillips
authors: Jonathan L
authors: JL
authors: Hager
authors: Kenneth M
authors: KM
authors: Goins
authors: Anna S
authors: AS
authors: Kitzmann
authors: Mark A
authors: MA
authors: Greiner
authors: Alex W
authors: AW
authors: Cohen
authors: Jeffrey D
authors: JD
authors: Welder
authors: Michael D
authors: MD
authors: Wagoner
mesh_terms: D000143:Acids / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000468:Alkalies / Q000009:adverse effects; D001187:Artificial Organs; D002057:Burns, Chemical / Q000503:physiopathology / Q000601:surgery*; D065306:Corneal Injuries / Q000503:physiopathology / Q000601:surgery*; D005126:Eye Burns / Q000139:chemically induced* / Q000601:surgery; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D014792:Visual Acuity
chemical_list: D000143:Acids; D000468:Alkalies