title: Boston type 1 keratoprosthesis for primary congenital glaucoma.
abstract: OBJECTIVE
  To evaluate the Boston type 1 keratoprosthesis (KPro-1) in treatment of eyes with primary congenital glaucoma.
  
  
  METHODS
  A retrospective review was performed of every eye with congenital glaucoma that was treated with a KPro-1 at a tertiary eye care centre between 1 January 2008 and 1 July 2014. The main outcome measures were visual outcome, prosthesis retention and postoperative complications.
  
  
  RESULTS
  Six eyes of six patients met the inclusion criteria. This included two paediatric patients, aged 6 months and 6 years, and four adults who were 27-33 years of age. Preoperatively, the best corrected visual acuity (BCVA) was worse than 20/400 in every eye. Three eyes had hand motions and one eye had light perception vision. After a mean follow-up period of 31 months (range 16-51 months), three eyes (50.0%) had a BCVA that was ≥20/400. Overall, the BCVA improved in four eyes (66.7%), and remained the same in two eyes (33.3%). The device was retained in six eyes (83.3%). One or more complications occurred in five eyes (83.3%) and included sterile corneal ulceration (three eyes), retroprosthetic membrane formation (three eyes), progressive glaucomatous optic neuropathy (two eyes), device extrusion (one eye) and an epiretinal membrane (one eye).
  
  
  CONCLUSIONS
  The Boston KPro-1 has an excellent prognosis for retention in eyes with congenital glaucoma. The visual prognosis remains guarded due to the high prevalence of pre-existing ocular comorbidity and the common occurrence of sight-threatening postoperative complications.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
authors.forename: Jaclyn M
authors.initials: JM
authors.lastname: Haugsdal
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Goins
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA Cornea Research Center, Stephen A Wynn Institute for Vision Research, Iowa City, Iowa, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Greiner
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
authors.forename: Young H
authors.initials: YH
authors.lastname: Kwon
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
authors.forename: Wallace L M
authors.initials: WL
authors.lastname: Alward
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA Cornea Research Center, Stephen A Wynn Institute for Vision Research, Iowa City, Iowa, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Wagoner
mesh_terms: D000328:Adult; D001187:Artificial Organs; D001705:Bioprosthesis; D002648:Child; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D005901:Glaucoma / Q000151:congenital / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007223:Infant; D007429:Intraocular Pressure; D011183:Postoperative Complications; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D014786:Vision Disorders / Q000534:rehabilitation; D014792:Visual Acuity / Q000502:physiology
keywords: Cornea; Glaucoma; Treatment Surgery