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Curr Opin OphthalmolJuly 20217 citations

Challenges in management of the Boston Keratoprosthesis Type 1.

Koo Ellen H, Hannush Sadeer B


AI Summary

This review highlights improved KPro outcomes but emphasizes persistent glaucoma challenges, crucial for managing high-risk corneal disease patients.

Abstract

Purpose of review: The Boston Keratoprosthesis Type 1 was pioneered by Claes Dohlman several decades ago. Since its inception, the device has undergone multiple revisions to address challenges associated with retroprosthetic membrane formation, retention, extrusion, stromal melt and endophthalmitis. Although visual outcomes and retention rates have improved, challenges, especially glaucoma, remain.

Recent findings: The Boston Keratoprosthesis Type I device has seen an increase in popularity because of the improvement in rates of retention and visual rehabilitation. Recent outcome studies have allowed clinicians to identify diagnoses and indications that can lead to more favorable results with the Boston Keratoprosthesis Type I device.

Summary

The Boston Keratoprosthesis Type I device continues to play a vital role in visual rehabilitation for eyes with very low chance of realistic allograft survival -- such as in eyes where corneal grafting is considered high-risk: eyes with corneal limbal stem cell failure, extensive deep corneal stromal neovascularization, and multiple allograft failures. This review article summarizes the perioperative and postoperative challenges, as well as other considerations associated with the device.


MeSH Terms

Artificial OrgansCorneaCorneal DiseasesDisease ManagementHumansProstheses and ImplantsProsthesis DesignProsthesis ImplantationVisual Acuity

Key Concepts5

Although visual outcomes and retention rates for the Boston Keratoprosthesis Type 1 device have improved, challenges, especially glaucoma, remain.

PrognosisReviewn=Not applicableCh12Ch27

The Boston Keratoprosthesis Type I device has seen an increase in popularity due to improved rates of retention and visual rehabilitation.

TreatmentReviewn=Not applicableCh27

Recent outcome studies have allowed clinicians to identify diagnoses and indications that can lead to more favorable results with the Boston Keratoprosthesis Type I device.

PrognosisReviewn=Not applicableCh27

The Boston Keratoprosthesis Type I device plays a vital role in visual rehabilitation for eyes with a very low chance of realistic allograft survival, such as in eyes where corneal grafting is considered high-risk (e.g., corneal limbal stem cell failure, extensive deep corneal stromal neovascularization, and multiple allograft failures).

TreatmentReviewn=Not applicableCh27

The Boston Keratoprosthesis Type 1 device has undergone multiple revisions to address challenges associated with retroprosthetic membrane formation, retention, extrusion, stromal melt, and endophthalmitis since its inception.

TreatmentReviewn=Not applicableCh27

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