Outcomes following Boston type 1 keratoprosthesis implantation in aniridia patients at the University of Montreal.

Purpose To describe outcomes after Boston Type 1 Keratoprosthesis (KPro) surgery in aniridic eyes. Design Retrospective, interventional case series. Methods setting: University-based tertiary care institution. patient population: Twenty-six aniridic eyes of 19 patients who underwent KPro implantation by a single experienced surgeon (M.H.-D.) between October 27, 2008 and January 16, 2012. main outcome measures: Preoperative and postoperative best-corrected visual acuity (BCVA), intraoperative and postoperative complications, and keratoprosthesis retention. Results Mean age was 56 years (range, 28–72); 10 patients were male. Seven patients had bilateral procedures. No intraoperative complications were encountered. Preoperatively, BCVA was 20/300 or worse in all eyes. After a mean follow-up time of 28.7 ± 13.5 months (range 4–50), the most recent BCVA was 20/200 or better in 14 eyes. Visual potential was limited by preexisting terminal glaucoma (n = 2), phthisis after retinal detachment (n = 4), and suprachoroidal hemorrhage (n = 2). Other postoperative complications included retroprosthetic membrane formation (n = 15), infectious keratitis (n = 1), extrusion (n = 2), and corneal melt (n = 4). Uncomplicated vitritis was reported in 6 eyes. No endophthalmitis occurred in this series. Most eyes have glaucoma and are on medical treatment. The overall retention rate of the initial prosthesis was 77%. Conclusions The prognosis in aniridic patients after KPro is variable. Meticulous follow-up and a subspecialty team approach are of utmost importance.