POSTOPERATIVE POSTERIOR SEGMENT COMPLICATIONS AFTER BOSTON TYPE 1 KERATOPROSTHESIS: Incidence, Risk Factors, and Intermediate-Term Outcomes. Issue 12 (December 2021)

• Record Type: Journal Article
• Authors: Bonnet, Clémence; Chehaibou, Ismael; Chen, Angela; Bourges, Jean-Louis; Markovic, Daniela; Hubschman, Jean-Pierre; Aldave, Anthony J.
• Is Part Of: Retina. Volume 41:Issue 12(2021)
• Publication Date: 2021-12
• Subjects: Boston type I keratoprosthesis -- cornea -- cystoid macular edema -- epiretinal membrane -- infectious keratitis -- persistent epithelial defect -- posterior segment complication -- retina -- retinal detachment -- vitritis; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000003233
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To identify the incidence of, risk factors for, and outcomes of posterior segment complications (PSC) after Boston Type 1 keratoprosthesis (KPro) implantation. Methods: Retrospective, consecutive case series of KPro procedures at the Stein Eye Institute. Data regarding ocular history, intraoperative details, postoperative management, and outcomes were collected. Eyes with at least one PSC (PSC group) were compared with eyes without PSC (No PSC group), and risk factors for PSC were determined. Results: Ninety-five PSC occurred in 69/169 eyes (40.8%), at a mean of 20.1 months after KPro implantation (0.01 complications/eye month). The median follow-up after KPro implantation was 44.0 months (range 3.0–174.4). The most common PSC were epiretinal membrane (16.6%), cystoid macular edema (12.4%), vitritis (11.2%), and retinal detachment (9.5%). Previous retinal detachment repair, concomitant intraocular lens removal, postoperative aphakia, and vitritis were risk factors for retinal detachment. Postoperative infectious keratitis was a risk factor for epiretinal membrane, cystoid macular edema, and vitritis. The posterior segment complication group had a significantly higher rate of eyes failing to maintain visual acuity ≥20/200 (HR = 2.28; 95% CI = 1.35–3.85) and KPro retention failure rate (HR = 1.66; 95% CI = 0.95–2.91). Conclusion: Posterior segment complications occur in approximately 40% of eyes after KPro implantation, resulting in reduced visual outcomes and KPro retention. Abstract : Supplemental Digital Content is Available in the Text.Posterior segment complications are frequent after Boston Type 1 keratoprosthesis implantation, leading to reduced long-term visual outcomes and retention rate. We identify risks factors for posterior segment complications, allowing ophthalmologists to determine which individuals with keratoprostheses are at increased risk of developing PSC, and modify risk factors when possible.