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Outcomes of the Boston type 1 and the Aurolab keratoprosthesis in eyes with limbal stem cell deficiency
  1. Swapna S Shanbhag1,
  2. Sirisha Senthil2,
  3. Ashik Mohamed3,
  4. Sayan Basu1,4
  1. 1The Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
  2. 2VST Glaucoma Center, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India
  3. 3Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, India
  4. 4Brien Holden Eye Research Centre (BHERC), L V Prasad Eye Institute, Hyderabad, Telangana, India
  1. Correspondence to Dr Sayan Basu, Director and D Balasubramanian Chair of Eye Research, Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad 500034, Telangana, India; sayanbasu{at}lvpei.org

Abstract

Purpose To analyse the outcomes of keratoprosthesis in eyes with limbal stem cell deficiency (LSCD) and to compare the outcomes in two different keratoprosthesis devices.

Methods This was a single-centre retrospective comparative case series which included 81 eyes of patients with severe bilateral corneal blindness secondary to LSCD. The patients underwent either Boston type 1 keratoprosthesis (Boston Kpro, n=44) or Aurolab keratoprosthesis (AuroKpro, n=37) implantation. The primary outcome measures of anatomical retention and functional recovery of 20/200 or better visual acuity at yearly time points until 5 years of follow-up were compared between the two groups.

Results The most common indication overall was chemical injury (64.2%). Anatomical retention rates were similar in the Boston Kpro (30/44, 68.2%) and AuroKpro (23/37, 62.2%) groups (p=0.89). Kaplan-Meier survival rates at 5 years of follow-up were greater for the Boston Kpro group with respect to both anatomical retention (58.51%±9% vs 43.8±12%; p=0.23) as well as functional recovery (42.61%±8% vs 35.03±10%; p=0.9); these differences were not statistically significant. Overall, the most common complication was new-onset glaucoma (59%; 48/81). The difference in incidence rate of this complication was not statistically significant among the two groups (p=0.09).

Conclusion Keratoprosthesis is an effective treatment option for patients with corneal blindness secondary to LSCD. In a setting where LSCD is a common cause of corneal blindness, the AuroKpro, when available can be considered an alternative to the Boston Kpro to achieve anatomical and functional success in patients who otherwise would not have access to this device.

  • cornea
  • ocular surface
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Footnotes

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  • Funding This work was funded by the Hyderabad Eye Research Foundation, Hyderabad, India.

  • Competing interests None declared.

  • Patient consent for publication All adults and legal guardians of children who underwent the surgical procedure gave informed written consent.

  • Ethics approval The study was approved by the Institutional Review Board and the Ethics Committee of the L.V. Prasad Eye Institute, Hyderabad and was conducted in strict adherence to the tenets of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Requests for data can be sent to the email address: sayanbasu@lvpei.org.

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