title: Long-term visual acuity, retention and complications observed with the type-I and type-II Boston keratoprostheses in an Irish population.
abstract: To evaluate the outcomes of the type-I and type-II Boston keratoprostheses in a single Irish centre.
  
  
  
  A retrospective chart review of keratoprosthesis implantations carried out in our institution from November 2002 to March 2014 was performed. All procedures were performed by a single surgeon (WP).
  
  
  
  Thirty-four keratoprosthesis implantations were carried out in 31 patients with a mean follow-up of 42±31 months (range 2-110 months). Seventeen patients were female (54.8%) and 14 were male (45.2%). The majority of keratoprostheses implanted were type-I (31/34, 91.2%), and three were type-II (3/34, 8.8%). Twenty-nine patients (85.3%) had an improvement in distance best-corrected visual acuity (BCVA) from baseline. Fifty per cent (17/34) of patients had a best-ever BCVA of at least 6/12. Eighteen patients (64.3%) retained a BCVA of at least 6/60 at 1 year. Over the course of follow-up, six keratoprostheses were explanted from six eyes of five patients, one of which was a type-II keratoprosthesis. Twenty-six patients (76.5%) developed postoperative complications. Complications included retroprosthetic membrane (18 patients, 52.9%), an exacerbation or new diagnosis of glaucoma (6 patients, 17.6%), endophthalmitis (5 patients, 14.7%) and retinal detachment (2 patients, 5.9%).
  
  
  
  These data demonstrate excellent visual acuity and retention outcomes in a cohort with a long follow-up period in a single centre. Complications remain a considerable source of morbidity. These outcomes provide further evidence for the long-term stability of type-I and type-II Boston keratoprostheses in the management of patients in whom a traditional graft is likely to fail.
authors.affiliation: Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland.
authors.forename: E S
authors.identifier: 0000-0002-3968-4855
authors.initials: ES
authors.lastname: Duignan
authors.affiliation: Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Ní Dhubhghaill
authors.affiliation: Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland.
authors.forename: C
authors.initials: C
authors.lastname: Malone
authors.affiliation: Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland.
authors.forename: W
authors.initials: W
authors.lastname: Power
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001187:Artificial Organs; D003315:Cornea / Q000601:surgery*; D003316:Corneal Diseases / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D019736:Prostheses and Implants; D011474:Prosthesis Design; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity
keywords: Cornea; Prosthesis; Treatment Surgery