Long-term Clinical Outcomes of Type 1 Keratoprosthesis: A 10-Year Experience

Purpose: To describe the outcome of type I keratoprosthesis (KPro) cases over 10 years of follow-up. Methods: This retrospective study analyzed data of 125 eyes of 124 patients, which underwent type I KPro between 2009 and 2014 (74: Boston KPro; 51: Auro KPro). Eyes with KPro exchange were included. Eyes that retained a KPro ≥10 years (24 eyes) were compared with the rest of the cohort (101 eyes). Results: The most common indication for surgery was limbal stem cell deficiency 74/125 (59%). The KPro retention was 51.2 ± 6% (anatomical) and 30.3 ± 4.7% with respect to visual recovery at 10 years for the cohort of 125 eyes. Among the 24 eyes (19%) that retained the KPro ≥10 years, 17 (71%) received Boston KPro and 7 (29%) received Auro KPro. Glaucoma was seen in 23 eyes (96%), of which 15 eyes (63%) required a glaucoma drainage device. Eighteen eyes (75%) retained the first implanted KPro. The preoperative median best-corrected visual acuity was significantly better in the group that retained the KPro ≥10 years (log MAR 2.8 vs. 3; P = 0.04). Incidence of glaucoma and retroprosthetic membrane was higher in the group that retained the KPro ≥10 years ( P <0.001). Conclusions: Nineteen percent of eyes operated for KPro over a 5-year period retained a KPro at ≥10 years. A higher incidence of complications was seen with longer follow-up emphasizing the need to schedule frequent follow-up visits, thus enhancing long-term outcomes.