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Long-term outcomes of Boston keratoprosthesis type I: the Chinese People’s Liberation Army General Hospital experience
  1. Li-Qiang Wang1,
  2. Teng-Yun Wu1,2,
  3. Xiao-Niao Chen1,
  4. Ze-Quan Xu1,
  5. Min Yang3,
  6. Ran Xiang1,
  7. Xiao Ma4,
  8. Shan Zhang1,
  9. Yi-Fei Huang1
  1. 1Department of Ophthalmology, General Hospital of People's Liberation Army, Beijing, China
  2. 2Department of Ophthalmology, Air Force Medical Center, Beijing, China
  3. 3Department of Ophthalmology, Chinese PLA 251 Hospital, Zhangjiakou, China
  4. 4Department of Ophthalmology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
  1. Correspondence to Professor Yi-Fei Huang, Department of Ophthalmology, General Hospital of People's Liberation Army, Beijing, China; 301yk{at}sina.com; Dr Li-Qiang Wang, Department of Ophthalmology, General Hospital of People's Liberation Army, Beijing, China; liqiangw301{at}163.com

Abstract

Purpose To report the long-term outcomes of Boston keratoprosthesis type I (B-KPro type I) implantation in the management of severe ocular surface disorders.

Methods Retrospective case series. Patients who underwent B-KPro type I implantation at the People’s Liberation Army General Hospital were enrolled between March 2011 and September 2019. Data regarding visual acuity (VA), B-KPro type I retention and postoperative complications were recorded and analysed.

Results A total of 103 eyes of 100 patients who underwent B-KPro type I implantation were included. The main indications were chemical burn (59.2%), ocular trauma (25.2%), herpetic keratitis (11.7%) and autoimmune diseases (3.9%). The percentage of eyes with postoperative VA of 10/200 or better was 82.7% at 6 months, 82.8% at 12 months, 77.9% at 2 years, 72.4% at 3 years, 71.1% at 4 years, 69.4% at 5 years, 58.9% at 6 years, 56.8% at 7 years and 42.9% at 8 years. Preoperatively, 8.7% eyes were diagnosed with new-onset glaucoma. Retroprosthetic membrane formation occurred in 19.4% eye. Corneal melting occurred in 18.4% eyes. Sterile vitritis was diagnosed in 4.9% eyes and infectious endophthalmitis in 2.9% eyes. Retinal detachment occurred in 0.9% eyes.

Conclusions In a Chinese patient group, B-KPro type I is a viable option for treating severe ocular surface disorders in eyes where conventional keratoplasty would have a poor prognosis, especially in patients with chemical and thermal burns. Improved visual outcomes and high retention rate can be achieved and maintained in most cases.

  • cornea
  • ocular surface

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Footnotes

  • L-QW and T-YW are joint first authors.

  • Presented at Presented in part as an oral presentation at 10th KPro Study Group Meeting.

  • Contributors L-Q W and Y-F H participated in the surgical procedure; T-Y W, X-N C and Z-Q X participated in data collation, data arrangement, paper writing and manuscript revision; M Y and R X participated in data collation; X M and S Z participated in the collection of some data.

  • Funding National Key R&D Program of China (Project No: 2017YFA0103204), National Natural Science Foundation of China (Project No. 81670830) and Chinese PLA General Hospital Translational Medicine Project (Project No. 2016TM-025), Chinese Capital Clinical Features Key Project (Project No: Z161100000516012).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study strictly adhered to the tenets of the Declaration of Helsinki and was approved by the ethics committee of the PLAGH.

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

  • Data availability statement Data including patients‘ VA, complications are available upon reasonable request through email liqiangw301@163.com.

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