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Subject Area

Pediatrics

Article Type

Original Study

Abstract

Objective The objective of this study was to evaluate the indications, outcomes, and complications of keratoprosthesis (type I Boston keratoprosthesis) in end-stage corneal disease. Background Corneal diseases are the leading cause of blindness worldwide, second after cataract. Eyes with deep corneal vascularization, limbal stem cell deficiency, autoimmune diseases, and chemical injury are prone to graft rejection. Keratoprosthesis offers visual rehabilitation in such situations. Patients and methods In this prospective clinical study, 10 eyes of 10 patients with an end-stage corneal disease underwent implantation of type I Boston keratoprosthesis, with a mean follow-up of 6.9 ± 1.4 months. The indications included multiple failed grafts (n = 6), ocular cicatricial pemphigoid (n = 3), and vascularized corneal opacity (n = 1). Antibiotic prophylaxis was administered postoperatively, and patients were followed up at 1 week, 1, 3, and 6 months. The main outcome measures were best-corrected visual acuity, retention of prosthesis, and complications. Results The most common indication for keratoprosthesis implantation was graft failure (6/10, 60%). Mean best-corrected visual acuity improved significantly after the surgery (P = 0.018). Nine (90%) patients had final visual acuity of 20/200 or better. Ten (100%) of 10 patients had retained keratoprosthesis. Complications occurred in only two (20%) patients, where one (10%) patient had keratitis and one (10%) patient had peripheral corneal melting. Conclusion Boston keratoprosthesis provides improved vision for patients having corneal blindness owing to end-stage corneal diseases; however, long-term studies are needed to monitor the late-onset complications in the postoperative period.

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