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Time to achieve best postoperative visual acuity following Boston keratoprosthesis surgery
  1. Jonathan El-Khoury1,
  2. Majd Mustafa2,
  3. Roy Daoud3,
  4. Mona Harissi-Dagher3
  1. 1Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
  2. 2Department of Ophthalmology, McGill University, Montreal, Quebec, Canada
  3. 3Ophthalmology, Université de Montréal, Montreal, Quebec, Canada
  1. Correspondence to Dr Roy Daoud, Ophthalmology, Université de Montréal, Montreal, H3T 1J4, Canada; roy.c.daoud{at}


Background/aims To evaluate the time needed for patients with Boston type 1 keratoprosthesis (KPro) to reach their best-corrected visual acuity (BCVA) and all contributing factors.

Methods We retrospectively reviewed 137 consecutive eyes from 118 patients, measured how long they needed to reach their BCVA and looked at factors that might affect this time duration including patient demographics, ocular comorbidities and postoperative complications.

Results The mean follow-up was 5.49 years. The median time to BCVA postoperatively was 6 months, with 47% of patients achieving their BCVA by 3 months. The mean best achieved logMAR visual acuity was 0.71, representing a gain of 6 lines on the Snellen visual acuity chart. Postoperative glaucoma, retroprosthetic membrane (RPM) and endophthalmitis prolonged this duration. We found no correlation between the following factors and time to BCVA: gender, age, indication for KPro surgery, primary versus secondary KPro, number of previous penetrating keratoplasties, previous retinal surgery, intraoperative anterior vitrectomy and preoperative glaucoma.

Conclusion In our retrospective cohort, the majority of subjects reached their BCVA between 3 and 6 months after KPro implantation. This duration was significantly prolonged by the development of postoperative glaucoma, RPM and endophthalmitis.

  • cornea
  • ocular surface
  • treatment surgery

Statistics from


  • Contributors MM, RD and MH-D were responsible for patient selection and data collection. JE-K, MM, RD and MH-D were responsible for statistical analysis, drafting and critical review of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

  • Data availability statement Data are available upon reasonable request. Deidentified participant data are available from Jonathan El-Khoury upon request.

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