title: Boston Type 1 Keratoprosthesis for Iridocorneal Endothelial Syndromes.
abstract: OBJECTIVE
  To evaluate the outcome of the Boston type 1 keratoprosthesis (KPro-1) in eyes with iridocorneal endothelial syndromes and failed keratoplasties.
  
  
  METHODS
  A retrospective review was performed of every eye with a history of iridocorneal endothelial syndrome and a failed corneal transplant that was treated with a KPro-1 at a tertiary eye care center between January 1, 2008, and July 1, 2014. The main outcome measures were visual outcome, prosthesis retention, and postoperative complications.
  
  
  RESULTS
  Four eyes met the inclusion criteria. Two eyes had essential iris atrophy and 2 eyes had Chandler syndrome. All 4 eyes had failed corneal transplants and successful glaucoma drainage devices. The mean patient age at the time of KPro-1 surgery was 68.3 years (range, 60-80 years). The mean postoperative follow-up duration was 47 months (range, 27-69 months). Preoperatively, the best-corrected visual acuity (BCVA) was worse than 20/200 in all 4 eyes, including 2 eyes that had hand motions vision. After KPro-1, all 4 eyes initially obtained a BCVA of ≥20/70. At the most recent examination, the BCVA was still ≥20/100 in 3 eyes. The KPro-1 device was retained in all 4 eyes. Postoperative complications included glaucoma progression (1 eye), a retroprosthetic membrane (1 eye), and sterile vitritis (1 eye).
  
  
  CONCLUSIONS
  The Boston KPro-1 may offer a better prognosis than repeat traditional keratoplasty in reestablishing corneal clarity in eyes with iridocorneal endothelial syndromes. Despite anatomic success, visual rehabilitation may be compromised by preexisting glaucomatous optic neuropathy and its postoperative progression.
authors.affiliation: *Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA; and †Cornea Research Center, Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Stephen A. Wynn Institute for Vision Research, Iowa City, IA.
authors.forename: David L
authors.initials: DL
authors.lastname: Phillips
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Goins
authors.forename: Mark A
authors.initials: MA
authors.lastname: Greiner
authors.forename: Wallace L M
authors.initials: WL
authors.lastname: Alward
authors.forename: Young H
authors.initials: YH
authors.lastname: Kwon
authors.forename: Michael D
authors.initials: MD
authors.lastname: Wagoner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D021522:Bioartificial Organs; D016039:Corneal Transplantation; D005260:Female; D020327:Glaucoma Drainage Implants; D006084:Graft Rejection / Q000601:surgery; D006801:Humans; D057129:Iridocorneal Endothelial Syndrome / Q000601:surgery*; D007498:Iris / Q000473:pathology; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology