Abstract
Keratoprosthesis has been used in adults since the mid-twentieth century. In early comparisons between PKs and KPros, the failure rate of PKs in high-risk patients can approach to 56 % at 3 years. However, with the advent of the Boston type I device, the outcomes of artificial keratoprosthesis implantation improved greatly. Best visual outcomes can be achieved in much less time with faster improvements overall. Complications include recurrent epithelial defects, retroprosthetic membranes, glaucoma, and a lifelong risk of endophthalmitis. There are multiple ways to prophylactically avoid these complications. In 2003, following the favorable experiences with the Boston KPro type 1 device in adults, the first infant keratoprosthesis procedure was performed. Because implantation of Boston type I keratoprostheses is still a balance between faster recovery and possible vision-threatening complications, is still an option even for people with poor prognosis, and necessitates a multidisciplinary approach and careful long-term follow-up.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Cardona H. Keratoprosthesis; acrylic optical cylinder with supporting intralamellar plate. Am J Ophthalmol. 1962;54:284–94.
Choyce DP. History of intraocular implants. Ann Ophthalmol. 1973;5(10):1113–20.
Aquavella JV, Qian Y, McCormick GJ, et al. Keratoprosthesis: current techniques. Cornea. 2006;25(6):656–62.
Stone W, Yasuda H, Refojo MF. A 15-year study of the plastic artificial cornea basic principles. In: King JH, McTigue JW, editors. The cornea world congress. Washington, DC: Butterworths; 1965. p. 654–71.
Aquavella JV, Qian Y, McCormick GJ, et al. Keratoprosthesis: the Dohlman-Doane device. Am J Ophthalmol. 2005;140(6):1032–8.
Khan BF, Harissi-Dagher M, Khan DM, et al. Advances in Boston keratoprosthesis: enhancing retention and prevention of infection and inflammation. Int Ophthalmol Clin. 2007;47:61–71.
Hicks CR, Fitton JH, Chirila TV, Crawford GJ, et al. Keratoprosthesis: advancing toward a true artificial cornea. Surv Ophthalmol. 1997;42(2):175–89.
Aquavella JV, Herzlich AA. Infant keratoprosthesis. Int Ophthalmol Clin. 2013;53(2):71–7.
Maguire MG, Stark WJ, Gottsch JD, et al. Risk factors for corneal graft failure and rejection in the collaborative corneal transplantation studies. Collaborative Corneal Transplantation Studies Research Group. Ophthalmology. 1994;101(9):1536–47.
Ma JJ, Graney JM, Dohlman CH. Repeat penetrating keratoplasty versus the Boston keratoprosthesis in graft failure. Int Ophthalmol Clin. 2005;45(4):49–59.
Dunlap K, Chak G, Aquavella JV, et al. Short-term outcomes of Boston type 1 keratoprosthesis implantation. Ophthalmology. 2010;117(4):687–92.
Aquavella JV, Gearinger MD, Akpek EK, et al. Pediatric keratoprosthesis. Ophthalmology. 2007;114(5):989–94.
Greiner MA, Li JY, Mannis MJ. Longer-term vision outcomes and complications with the Boston Type I keratoprosthesis at the University of California, Davis. Ophthalmology. 2011;11:1543–50.
Zerbe BL, Belin MW, Ciolino JB, Boston Type I Keratoprosthesis Study Group. Results from the multicenter Boston type I keratoprosthesis study. Ophthalmology. 2006;113:1779–84.
Aldave AJ, Kamal KM, Vo RC, Yu F. The Boston type I keratoprosthesis: improving outcomes and expanding indications. Ophthalmology. 2009;116:640–51.
Chew HF, Ayres BD, Hammersmith KM, et al. Boston keratoprosthesis outcomes and complications. Cornea. 2009;28:989–96.
Bradley JC, Hernandez EG, Schwab IR, Mannis MJ. Boston type I keratoprosthesis: the University of California Davis experience. Cornea. 2009;28:321–7.
Eifrig C, Flynn Jr HW, Scot IU, Newton J. Acute onset postoperative endophthalmitis: review of incidence and visual outcomes (1995–2001). Ophthalmic Surg Lasers. 2002;33:373–8.
Taban M, Behrens A, Newcomb RL, et al. Incidence of acute endophthalmitis following penetrating keratoplasty: a systematic review. Arch Ophthalmol. 2005;123:605–9.
Endophthalmitis Vitrectomy Study Group. Results of the Endophthalmitis Vitrectomy Study: a randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative endophthalmitis. Arch Ophthalmol. 1995;113:1479–96.
Ramchandran RS, DiLoreto DA, Chung MM, Kleinman DM, Plotnik RP, Graman P, Aquavella JV. Infectious endophthalmitis in adult eyes receiving Boston type I keratoprosthesis. Ophthalmology. 2012;119:674–81.
Nouri M, Terada H, Alfonso EC, et al. Endophthalmitis after keratoprosthesis: incidence, bacterial causes, and risk factors. Arch Ophthalmol. 2001;119:484–9.
Robert MC, Moussally K, Harissi-Dagher M. Review of endophthalmitis following Boston keratoprosthesis type I. Br J Ophthalmol. 2012;96:776–80.
Yaghouti F, Nouri M, Abad JC, et al. Keratoprosthesis preoperative prognostic categories. Cornea. 2001;20:19–23.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Herzlich, A.A., Aquavella, J.V. (2015). Boston KPRO Type I: Outcomes. In: Cortina, M., de la Cruz, J. (eds) Keratoprostheses and Artificial Corneas. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55179-6_10
Download citation
DOI: https://doi.org/10.1007/978-3-642-55179-6_10
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-55178-9
Online ISBN: 978-3-642-55179-6
eBook Packages: MedicineMedicine (R0)