Boston kpro type I as a viable alternative to visual rehabilitation in aniridia patients: Advances and limitations

Abstract

The purpose of this chapter is to describe the experience of Boston Type 1 Keratoprosthesis in Aniridia. Aniridia-associated keratopathy (AAK) affects up to 90 % of aniridic patients and may significantly decrease best-corrected acuity. Poor outcomes of penetrating keratoplasty in aniridia have been reported for over 20 years. Limbal stem cell transplantation can help restore a healthy ocular surface, but requires long term systemic immunosuppression. Boston type 1 Keratoprosthesis implantation represents a promising alternative for visual rehabilitation in AAK patients. The central PMMA optic is unaffected by corneal graft vascularization or conjunctivalization, and may be customized for aphakia or pseudophakia. Multiple studies have reported improved visual outcomes after Kpro implantation with device retention rates of 70 % or greater. Complications include retroprosthetic membranes, corneal melt, device extrusion, and glaucoma.