Purpose: This study aims to determine whether frozen corneas can be successfully used as carriers of the Boston keratoprosthesis (KPro).
Methods: Prospective study of 37 patients undergoing KPro surgery with fresh or frozen corneas as carriers. Patients were randomized to receive either a fresh corneal graft or a frozen corneal graft during implantation of the Boston KPro. The randomization depended on availability of fresh versus frozen corneas offered by the local eye bank. All surgeries were performed by the same experienced surgeon. Outcome measures included retention of the device, level of preoperative and postoperative visual acuities (VAs), and complications.
Results: The indication for Boston KPro was corneal graft failure in 24 eyes; 13 patients had KPro as a primary procedure. The assembly of the Boston KPro and surgery were uneventful in all cases. Mean follow-up was 9.65 months. Median preoperative VA was counting fingers (range, 20/100 to light perception) in the fresh cornea group (19 eyes) and hand motions (range, 20/150 to light perception) in the frozen cornea group (18 eyes). Median postoperative VA were 20/150 (range, 20/30 to hand motions) and 20/150 (range, 20/40 to counting fingers) in the fresh and frozen cornea groups, respectively. Inflammation and retroprosthetic membrane formation were the most common complications with similar rates between the 2 groups. The device retention rate was 100% at the end of the follow-up period.
Conclusions: Frozen and fresh corneal donors seem equally efficient and safe as carriers of the Boston KPro with similar recuperation of VA and no untoward complications, such as melt, leaks, or endophthalmitis.
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[Retroprosthetic membrane formation in Boston keratoprosthesis type 1: Incidence, predisposing factors, complications, and treatment].
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Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Article Synopsis
- The study aimed to evaluate the short-term outcomes of a modified Boston keratoprosthesis device (ORC-KPro) in patients suffering from end-stage corneal blindness.
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Retina Service and Cornea Service, Department of Ophthalmology, Mass Eye and Ear, Mass General Brigham Harvard Medical School, Boston, Massachusetts.
The Boston Keratoprosthesis type I (KPro-I) has been shown to be successful in restoring vision after severe ocular burns; however, its long-term outcomes in phthisical eyes have rarely been reported. A monocular woman with a history of severe alkali chemical injury necessitating facial transplantation presented with a light perception left eye after a complicated course, including failed KPro-I, therapeutic penetrating keratoplasty, endophthalmitis, hypotony, total retinal detachment, and structural changes, including a shrunken 18 mm axial length and eye wall thickening. The patient underwent a combined vitrectomy with silicone oil and KPro-I implantation, resulting in her regaining ambulatory visual acuity (20/250) at 3 years' follow-up
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