title: The Boston Keratoprosthesis type 1 as primary penetrating corneal procedure.
abstract: OBJECTIVE
  Penetrating keratoplasty (PK) has a poor prognosis in certain corneal eye diseases. The safety and efficacy of Boston type 1 Keratoprosthesis (KPro) surgery as a primary penetrating corneal surgery were evaluated for patients with corneal blindness and poor prognosis for PK.
  
  
  METHODS
  In this retrospective interventional comparative study, all patients who underwent KPro implantation by a single surgeon between October 2008 and March 2011 at the Centre Hospitalier de l'Université de Montréal were divided into two groups. Thirty patients with KPro as a primary procedure (group 1) were compared with 40 patients who had PK prior to KPro (group 2). A chart review examining preoperative and postoperative best-corrected visual acuity (BCVA), intraoperative and postoperative complications and KPro retention rate over the first postoperative year was performed.
  
  
  RESULTS
  Preoperative BCVA was 20/200 or better in 10% of eyes in group 1 (range 20/150 light perception (LP)), and in 5% of eyes in group 2 (range 20/100 LP; p=0.42). BCVA was significantly better in group 1 throughout the follow-up (p<0.05). At 12 months, 87% and 63% of eyes achieved a BCVA better than 20/200 in groups 1 and 2, respectively (p<0.05). The complication rates and retention rate were similar in the two groups.
  
  
  CONCLUSIONS
  This study demonstrates that the Boston KPro implantation may be successful as a primary procedure in patients at high risk of failure with traditional PK. Further, there appears to be a visual benefit to primary KPro surgery.
authors.affiliation: From the Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montréal, Québec, Canada.
authors.forename: Raphaëlle
authors.initials: R
authors.lastname: Fadous
authors.affiliation: From the Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montréal, Québec, Canada.
authors.forename: Samuel
authors.initials: S
authors.lastname: Levallois-Gignac
authors.affiliation: From the Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montréal, Québec, Canada.
authors.forename: Louis
authors.initials: L
authors.lastname: Vaillancourt
authors.affiliation: From the Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montréal, Québec, Canada.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Robert
authors.affiliation: From the Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montréal, Québec, Canada.
authors.forename: Mona
authors.initials: M
authors.lastname: Harissi-Dagher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001187:Artificial Organs; D001705:Bioprosthesis; D003315:Cornea; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
keywords: Anterior chamber; Cornea; Prosthesis; Treatment Surgery