title: Long-Term Results of the Boston Keratoprosthesis for Unilateral Corneal Disease.
abstract: OBJECTIVE
  To report the results of unilateral implantation of a Boston keratoprosthesis (BKPro) in patients with good visual acuity in the fellow eye.
  
  
  METHODS
  A retrospective analysis of 37 eyes of 37 patients who underwent an optical BKPro and had a preoperative best-corrected visual acuity (BCVA) of 20/40 or better in the fellow eye at Wills Eye Hospital from September 2005 to November 2013 was performed. Patients were excluded if they had less than 1 year of postoperative follow-up.
  
  
  RESULTS
  The mean follow-up after BKPro implantation was 31.7 months (range, 12-78 months; SD, 21). Twenty-eight patients underwent a BKPro for failed penetrating keratoplasty, and 9 patients underwent a primary BKPro. The most common complications were elevated intraocular pressure and retroprosthetic membrane formation in 16 eyes (43%) each. The mean final BCVA (1.0 ± 0.8 logMAR; median, 1.0 logMAR) was statistically better than the mean preoperative BCVA (1.8 ± 0.2 logMAR; median, 1.8 logMAR) (P < 0.001). The probability of postoperative BCVA of 20/200 or better was 54.1% with an average 45.1 ± 4.7 (confidence interval: 35.9-54.3) months of follow-up. The probability of postoperative BCVA of 20/40 or better was 37.8% with an average 51.8 ± 4.9 (confidence interval: 42.0-61.5) months of follow-up.
  
  
  CONCLUSIONS
  Half of the patients in our study achieved the minimum visual acuity required for binocular functioning, whereas one-third of the patients achieved a BCVA somewhat similar to that of the contralateral eye. The complications were similar to those reported previously with good retention of the device. BKPro implantation is a reasonable option for patients with good vision in the fellow eye.
authors.affiliation: *Cornea Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA; and †Cornea Service, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kosker
authors.forename: Kunal
authors.initials: K
authors.lastname: Suri
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Rapuano
authors.forename: Brandon D
authors.initials: BD
authors.lastname: Ayres
authors.forename: Parveen K
authors.initials: PK
authors.lastname: Nagra
authors.forename: Irving M
authors.initials: IM
authors.lastname: Raber
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Hammersmith
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001187:Artificial Organs; D001705:Bioprosthesis; D002648:Child; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D016039:Corneal Transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D017211:Treatment Failure; D014786:Vision Disorders / Q000534:rehabilitation*; D014792:Visual Acuity / Q000502:physiology; D019987:Persons with Visual Disabilities / Q000534:rehabilitation