Outcomes of Repeat Boston Type 1 Keratoprosthesis Implantation.
OBJECTIVE
To describe the outcomes and prognostic characteristics of patients who had a repeat Boston type 1 keratoprosthesis (KPro) implantation.


METHODS
Retrospective case series.


METHODS
setting: Data regarding preoperative clinical and demographic characteristics and postoperative course during initial and repeat KPro placement were collected at multiple centers across the country.


METHODS
Forty-eight eyes underwent explantation of KPro owing to complications between September 2003 and August 2014 at 5 participating tertiary eye care centers in the United States. Of those, 36 eyes that received a subsequent replacement device were included.


METHODS
Visual acuity (VA) outcomes and postoperative complications.


RESULTS
Ocular surface disease was significantly more common in eyes that required a device explantation, compared to those that retained the device (P < .001). Sixty-seven percent of eyes (24/36) achieved VA ≥ 20/200 vision after the repeat KPro. The probability of these 24 eyes maintaining VA ≥ 20/200 after the repeat KPro was 87% at 1 year and 75% at 2 years. Predictors of the ability to maintain vision ≥ 20/200 following surgery were a better last-recorded vision before explantation (P = .0002) and better vision immediately after repeat KPro (P < .001).


CONCLUSIONS
Ocular surface disease and its complications were associated with more frequent device removal. In these patients, repeat KPro resulted in restoration of vision. A reasonable visual acuity prior to device removal was associated with favorable long-term postoperative visual acuity and retention.
Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
Sumayya
S
Ahmad
Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
Priya M
PM
Mathews
Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
Divya
D
Srikumaran
The Stein Eye Institute, Los Angeles, California.
Anthony J
AJ
Aldave
The Stein Eye Institute, Los Angeles, California.
Tamara
T
Lenis
Flaum Eye Institute, Rochester, New York.
James V
JV
Aquavella
Wills Eye Institute, Philadelphia, Pennsylvania.
Sadeer B
SB
Hannush
University of Arizona Department of Ophthalmology, Tucson, Arizona.
Michael
M
Belin
Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: esakpek@jhmi.edu.
Esen Karamursel
EK
Akpek
D001187:Artificial Organs; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D011379:Prognosis; D019919:Prosthesis Implantation / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology