title: [Boston-keratoprosthesis : Preliminary experiences in 13 high-risk eyes from the Department of Ophthalmology of the University of Cologne].
abstract: BACKGROUND
  Corneal transplantation in high-risk eyes remains a challenge. The Boston keratoprosthesis (B-KPro) is a final option for patients with end-stage corneal disease and a poor prognosis with conventional penetrating keratoplasty. In this article the results of the first 13 eyes that received a B-KPro type I at the Department of Ophthalmology, University of Cologne, Germany are reported and the usefulness of postoperative slit-lamp optical coherence tomography (SL-OCT) for control purposes is evaluated.
  
  
  METHODS
  All recipients of a B-KPro type I between September 2013 and May 2015 were included in the study. The feasibility of the operation, clinical outcomes, complications and revision surgery were investigated. The visualization of wound healing by SL-OCT was analyzed.
  
  
  RESULTS
  The age of the patients ranged from 26 to 92 years (mean 57.3 ± 20.9 years). In all 13 eyes from 12 patients (6 males and 6 females) dense corneal opacification with vascularization and sometimes also conjunctivalization was present. Preoperative visual acuity was reduced and ranged from mere light perception up to a maximum of 1/35 eye chart. All 13 eyes could be supplied with a B-KPro type I without any intraoperative complications, in 6 eyes no significant postoperative complications occurred, whereas in 7 eyes various additional surgical interventions were required and 1 B-KPro could not be preserved. Postoperative visual acuity ranged from light perception to 20/32 and was significantly improved in 85 % of the treated eyes. The use of SL-OCT reproducibly allowed the postoperative assessment of stromal thinning.
  
  
  CONCLUSIONS
  The B-KPro provides the possibility of visual rehabilitation in high-risk eyes that could never be achieved without artificial cornea replacement. Despite higher complication rates this technique represents a significant progress in the surgical treatment of complex corneal pathologies. Regular and intensive postoperative controls are necessary to achieve good long-term results.
authors.affiliation: Zentrum für Augenheilkunde, Universität zu Köln, Universitätsklinikum Köln, Kerpener Straße 62, 50924, Köln, Deutschland. friederike.schaub@uk-koeln.de.
authors.forename: F
authors.initials: F
authors.lastname: Schaub
authors.affiliation: Zentrum für Augenheilkunde, Universität zu Köln, Universitätsklinikum Köln, Kerpener Straße 62, 50924, Köln, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Hos
authors.affiliation: Zentrum für Augenheilkunde, Universität zu Köln, Universitätsklinikum Köln, Kerpener Straße 62, 50924, Köln, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Bucher
authors.affiliation: Zentrum für Augenheilkunde, Universität zu Köln, Universitätsklinikum Köln, Kerpener Straße 62, 50924, Köln, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Siebelmann
authors.affiliation: Zentrum für Augenheilkunde, Universität zu Köln, Universitätsklinikum Köln, Kerpener Straße 62, 50924, Köln, Deutschland.
authors.forename: B O
authors.initials: BO
authors.lastname: Bachmann
authors.affiliation: Zentrum für Augenheilkunde, Universität zu Köln, Universitätsklinikum Köln, Kerpener Straße 62, 50924, Köln, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Cursiefen
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001187:Artificial Organs; D003316:Corneal Diseases / Q000175:diagnosis* / Q000628:therapy*; D016039:Corneal Transplantation / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000379:methods; D016896:Treatment Outcome
keywords: Artificial cornea; Complications; Corneal diseases; Keratoplasty; Split lamp optical coherence tomography
references.citation: Can J Ophthalmol. 2011 Apr;46(2):164-8
references.pmid: 21708085
references.citation: Ocul Immunol Inflamm. 2011 Dec;19(6):413-8
references.pmid: 22106908
references.citation: Nippon Ganka Gakkai Zasshi. 2013 Jan;117(1):35-43
references.pmid: 23424974
references.citation: Cornea. 2015 Sep;34(9):1057-62
references.pmid: 26114818
references.citation: Br J Ophthalmol. 2016 Apr;100(4):549-52
references.pmid: 26276169
references.citation: J Ophthalmic Vis Res. 2015 Jan-Mar;10(1):26-32
references.pmid: 26005549
references.citation: Ophthalmology. 2013 Jun;120(6):1195-200
references.pmid: 23499061
references.citation: Curr Opin Ophthalmol. 2009 Jul;20(4):299-307
references.pmid: 19417653
references.citation: Arq Bras Oftalmol. 2012 Nov-Dec;75(6):447
references.pmid: 23715153
references.citation: Cornea. 2014 Sep;33(9):914-8
references.pmid: 25014143
references.citation: Ophthalmologe. 2012 May;109(5):454-61
references.pmid: 22581046
references.citation: JAMA Ophthalmol. 2015 Oct;133(10):1133-4
references.pmid: 26226302
references.citation: Ophthalmology. 2015 Jul;122(7):1504-11
references.pmid: 25934510
references.citation: Ophthalmology. 2014 Nov;121(11):2159-64
references.pmid: 25017414
references.citation: Eye Contact Lens. 2014 May;40(3):185-9
references.pmid: 24508771
references.citation: Am J Ophthalmol. 2013 May;155(5):814-22
references.pmid: 23352344
references.citation: Ophthalmologe. 2013 Jul;110(7):614-21
references.pmid: 23740158
references.citation: Cornea. 2006 Jul;25(6):656-62
references.pmid: 17077656
references.citation: Klin Monbl Augenheilkd. 2014 Jun;231(6):619-25
references.pmid: 24940760
references.citation: Clin Ophthalmol. 2015 Apr 16;9:697-720
references.pmid: 25945031
references.citation: Ophthalmologe. 2014 Nov;111(11):1010-8
references.pmid: 25388085
references.citation: JAMA Ophthalmol. 2014 Sep;132(9):1133-6
references.pmid: 25010136
references.citation: Ophthalmologe. 2010 Apr;107(4):370-6
references.pmid: 20567957
references.citation: Int Ophthalmol. 2016 Feb;36(1):73-8
references.pmid: 25975459
references.citation: Cornea. 2001 Jan;20(1):19-23
references.pmid: 11188997
references.citation: Eye Contact Lens. 2015 Nov;41(6):334-40
references.pmid: 26020487
references.citation: Ophthalmology. 2006 Oct;113(10):1779.e1-7
references.pmid: 16872678
references.citation: Surv Ophthalmol. 2012 May-Jun;57(3):236-52
references.pmid: 22516537
references.citation: Retina. 2013 Mar;33(3):532-41
references.pmid: 23073339
references.citation: Saudi J Ophthalmol. 2015 Jul-Sep;29(3):212-21
references.pmid: 26155082