Retroprosthetic Membrane Formation in Boston Keratoprosthesis: A Case–Control-Matched Comparison of Titanium Versus PMMA Backplate. Issue 2 (February 2018)

• Record Type: Journal Article
• Authors: Talati, Rushi K.; Hallak, Joelle A.; Karas, Faris I.; de la Cruz, Jose; Cortina, M. Soledad
• Is Part Of: Cornea. Volume 37:Issue 2(2018)
• Publication Date: 2018-02
• Subjects: Boston keratoprosthesis (KPro) -- retroprosthetic membrane (RPM) -- titanium backplate -- PMMA backplate; Cornea -- Periodicals; Cornea -- Periodicals; Cornée -- Périodiques; 617.719
• DOI: 10.1097/ICO.0000000000001462
• Languages: English
• ISSNs: 0277-3740

Abstract

Abstract : Purpose: Retroprosthetic membrane (RPM) formation is the most common complication after Boston type 1 keratoprosthesis (KPro) implantation. It affects visual acuity and can predispose to corneal melt. Two KPro backplate materials are available: titanium and polymethyl methacrylate (PMMA). This study investigates the influence of the KPro backplate material on visually significant RPM formation. Methods: A retrospective case–control-matched study involving 40 patients; 20 eyes implanted with a titanium backplate KPro were case-matched with 20 eyes implanted with a PMMA backplate KPro between 2007 and 2015 with 1-year minimum follow-up. Results: The mean follow-up duration was 28.1 ± 8.9 and 53.6 ± 24.3 months in the titanium and PMMA groups, respectively. At 12 months postoperatively, 7 eyes with titanium and 6 eyes with PMMA backplates developed a visually significant RPM. By the end of the study, a total of 11 eyes with titanium and 9 eyes with PMMA KPros developed a visually significant RPM. There was no statistically significant difference between both groups. Three of 11 eyes with titanium KPros that had a visually significant RPM required surgical membranectomy, whereas all eyes with PMMA KPros were successfully treated with the yttrium-aluminum-garnet laser. Recurrence of RPMs was found in 7/11 eyes in the titanium group and 2/9 eyes in the PMMA group with no statistical significance. Conclusions: Titanium backplate KPros do not significantly reduce RPM formation compared with PMMA backplate KPros in a case–control-matched setting. A larger prospective study is warranted to evaluate comparative long-term performance and guide newer designs.