TY - JOUR T1 - Boston keratoprosthesis type I in the elderly JF - British Journal of Ophthalmology JO - Br J Ophthalmol SP - 514 LP - 518 DO - 10.1136/bjophthalmol-2015-307868 VL - 101 IS - 4 AU - Gelareh Homayounfar AU - Christina M Grassi AU - Ahmad Al-Moujahed AU - Kathryn A Colby AU - Claes H Dohlman AU - James Chodosh Y1 - 2017/04/01 UR - http://bjo.bmj.com/content/101/4/514.abstract N2 - Background/aims To determine the outcomes of Boston type I keratoprosthesis implanted in elderly patients.Methods A retrospective case series was performed on patients at least 75 years old who received the Boston type I keratoprosthesis between 1 January 2007 and 31 December 2012. Preoperative diagnosis, interval visual acuity, keratoprosthesis retention and postoperative complications were recorded for each patient.Results Forty-four Boston type I keratoprostheses were implanted in 44 eyes of 43 patients. The most common indication for surgery was corneal graft failure (n=23; 52.3%) followed by corneal scar (n=8; 18.2%) and limbal stem cell dysfunction (n=8; 18.2%). All patients had preoperative visual acuity of ≤20/200. Thirty-six of 44 (82%) patients achieved visual acuity of 20/200 or better postoperatively, and 20 of those (55.6%) maintained 20/200 or better for 1 year after surgery. The median length of follow-up was 825 days (range: 27–2193 days), and at the last follow-up visit, 20 of 44 (45.5%) had 20/200 or better vision. The median best-corrected visual acuity (logMAR) improved from 2.6 preoperatively to 1.0 at 1 year postoperative (p<0.00001). Device retention at 1 year postoperative was 88.9%. The most common postoperative complications were retroprosthetic membrane formation in 20 patients (45.5%) and cystoid macular oedema in six patients (13.6%). One patient developed keratitis and consecutive endophthalmitis 2 months after surgery and required enucleation.Conclusions Boston type I keratoprosthesis is an effective modality in corneal blindness in elderly patients. Failure to restore or maintain ambulatory vision was typically due to non-corneal comorbidities, often unrelated to the keratoprosthesis. ER -