The Boston Keratoprosthesis is known for excellent long-term stability and safety, and it can provide normal vision for as long as the rest of the eye remains undamaged.
Because of possible complications that can result after corneal surgery, patients with keratoprosthesis require frequent ophthalmologic examinations in the beginning of postoperative care. Patients are normally seen the day following surgery, as well as during the first and second weeks after surgery. Bimonthly check-ups are recommended during the first year. After this, examination by the surgeon every three to four months is normally performed.
The Boston Keratoprothesis can be used after standard corneal transplants have failed or when such transplants would be unlikely to succeed. Keratoprosthesis implantation is a procedure specifically designed to help patients whose conditions are the most difficult to treat.
When the cornea becomes diseased and vision is significantly compromised, corneal transplantation may be necessary. with donor tissue is the most common treatment for corneal opacity. However, in certain severe corneal opacities, there is a high failure rate. An alternate treatment is the Boston Keratoprosthesis (Kpro) which acts as an artificial cornea.
Liu, C., Paul, B., Tandon, R., Lee, E., Fong, K., Mavrikakis, I., et. al. (2005) The Osteo-Odonto-Keratoprosthesis (OOKP) 20:113–128. (Level 4 evidence)
The Boston Keratoprosthesis is made of plastic (PMMA) or titanium with excellent tissue tolerance and optical properties. It consists of three parts, which when fully assembled have the shape of a collar-button.
Bradley, J., Hernandez, E., Schwab, I., & Mannis, M. (2009). Boston type 1 keratoprosthesis: the University of California Davis experience. , 28 (3) 321-327. (Level 4 evidence - Independent study)
Aldave, A.J., Kamal, K.M., Vo, R.C., & Yu, F. (2009). The Boston type 1 keratoprosthesis: improving outcomes and expanding indications. , 116 (4), 640-651. Abstract retrieved July 10, 20215 from PubMed database.
Ahmad, S., Mathews, P., Lindsley, K., Alkharashi, M., Hwang, F., Ng, S., et al. (2016). Boston type 1 keratoprosthesis versus repeat donor keratoplasty for corneal graft failure. A systematic review and meta-analysis. 2016; 123:165-177. (Level 1 evidence)
Keratoprosthesis (KP) is an artificial cornea that is intended to replace the opacified corneal tissue and restore vision when severe bilateral corneal disease exists (e.g., prior failed cadaveric corneal transplant, chemical injury or certain immunological condition). Many people with corneal disease can benefit from corneal transplantation involving tissue from human (cadaveric) donors. This is the most common treatment for severe corneal opacity. However, in some cases, this treatment fails. KP has been developed for use when corneal transplant is not an option. A permanent keratoprosthesis device (i.e., Boston KPro) is implanted in the eye to allow the transmission of light through an artificial cornea.
It should be possible to manufacture this threadless device by molding rather than by machining, which should radically decrease production cost.
Boston Keratoprosthesis; Threadless Device
Lee, W., Shtein, R., Kaufman, S., Deng, S., and Rosenblatt, M. (2015). Boston keratoprosthesis: outcomes and complications: a report by the American Academy of Ophthalmology. , 122 (7), 1504-1511. Abstract retrieved July 9, 2015 from PubMed database.