title: Outcomes of bilateral sequential implantation of the Boston keratoprosthesis type 1.
abstract: OBJECTIVE
  To evaluate the risks and benefits of sequential bilateral Boston type 1 keratoprosthesis (KPro) implantation for bilateral corneal blindness.
  
  
  METHODS
  Comparative retrospective study.
  
  
  METHODS
  Patients who underwent a sequential bilateral KPro surgery.
  
  
  METHODS
  All 11 patients who underwent sequential bilateral KPro surgery at the Centre Hospitalier de l'Université de Montréal between October 2008 and October 2011 were recruited. Data from the 22 patient eyes in our study were separated in 2 groups based on the first (group 1) or second eye (group 2) implanted with the Kpro. Both groups were then compared for the best corrected visual acuity (BCVA) and complications. Bilateral BCVA following both surgeries and the overall number of complications that affected each patient after both interventions were also analyzed.
  
  
  RESULTS
  At 24 months, BCVA was 20/150 in group 1 and 20/200 in group 2 (p = 0.67). Throughout the study, there was no significant difference in BCVA between the 2 groups (p > 0.05), and bilateral BCVA was similar. The complication rate was comparable in the 2 groups. Patients had a mean of 2.45 complications following the first surgery and a mean of 5.27 in both eyes combined after the second intervention (p = 0.03).
  
  
  CONCLUSIONS
  Because visual gain observed following the second surgery was the same as that with the first and multiple surgeries increased the number of complications for each patient, we recommend saving bilateral KPro implantation for cases in which the first eye with KPro develops a disease limiting its visual potential.
authors.affiliation: Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montréal, Qué.
authors.forename: Louis
authors.initials: L
authors.lastname: Vaillancourt
authors.affiliation: Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montréal, Qué.
authors.forename: Eleni
authors.initials: E
authors.lastname: Papanagnu
authors.affiliation: Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montréal, Qué.
authors.forename: Marwan
authors.initials: M
authors.lastname: Elfekhfakh
authors.affiliation: Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montréal, Qué.
authors.forename: Raphaelle
authors.initials: R
authors.lastname: Fadous
authors.affiliation: Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montréal, Qué. Electronic address: monadagher@hotmail.com.
authors.forename: Mona
authors.initials: M
authors.lastname: Harissi-Dagher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001187:Artificial Organs; D003315:Cornea / Q000601:surgery*; D003316:Corneal Diseases / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D019736:Prostheses and Implants; D011474:Prosthesis Design; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors; D014792:Visual Acuity / Q000502:physiology*