Long-term outcomes of the aphakic snap-on Boston type I keratoprosthesis at the bascom palmer eye institute

Allister Gibbons, Ella Leung, Luis Haddock, Carlos A. Medina, Viviana Fernandez, Jean-Marie A Parel, Heather A. Durkee, Guillermo Amescua, Eduardo C Alfonso, Victor L Perez Quinones

Research output: Contribution to journalArticle

3 Scopus citations


Purpose: To determine the indications, long-term clinical and visual outcomes, and complications of the aphakic snap-on type I Boston keratoprosthesis (KPro). Design: Retrospective, non-comparative case series. Methods: Forty-five eyes of 43 patients with type I aphakic snap-on KPros with at least 1 year of follow-up were included. The past medical histories, preoperative indications, best-corrected visual acuities (BCVAs), postoperative complications, and retention rates were analyzed. Results: The most common indication for KPro implantation was a failed corneal graft (89%). The mean preoperative BCVA was count fingers–hand motion (2.14±0.45 logarithm of minimum angle of resolution [logMAR]), which initially improved to 20/200 (1.04±0.85 logMAR; P<0.0001). At the last examination, 24 eyes (53%) maintained some visual gain, 22% retained their preoperative visual acuity, and 24% lost vision due to postoperative events and underlying ocular comorbidities. Postoperative complications included retroprosthetic membranes (8/45, 18%), corneal melts (5/45, 11%), glaucoma progression (6/45, 13%), and endophthalmitis or sterile vitritis (6/45, 13%). The KPro retention rate was 89%, with a mean follow-up of 51 months. The mean BCVA at the last visit was 20/1,400 (1.82±0.92 logMAR). Conclusion: Most patients experienced improved visual acuity after the implantation of the aphakic, snap-on type I KPro; however, the visual gains were not sustained over time, correlating with the onset of postoperative complications.

Original languageEnglish (US)
Pages (from-to)331-337
Number of pages7
JournalClinical Ophthalmology
StatePublished - Feb 15 2018



  • Aphakia
  • Corneal blindness
  • Keratoprosthesis
  • Penetrating keratoplasty
  • Snap-on type I keratoprosthesis

ASJC Scopus subject areas

  • Ophthalmology

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