By James Chodosh, MD, MPH
    Subspecialty Day 2011: Cornea
    Cornea/External Disease

    The Boston keratoprosthesis (KPro) is an effective option for patients with corneal allograft failure. As of 2011 it is the most prevalent keratoprosthesis in the United States, the Americas, and Western Europe. In this presentation, Dr. James Chodosh reviews the spectrum of diseases that cause limbal stem cell failure and the indications for and risks associated with Boston KPro implantation.

    Dr. Chodosh concludes that aniridia patients are good candidates for the surgery, though simultaneous implantation of a glaucoma drainage device should be considered in these cases. Patients with severe chemical burns may benefit from a Boston KPro, but they are at increased risk of glaucoma and retinal detachment following implantation. The Boston KPro is least effective in patients with mucous membrane pemphigoid or Stevens-Johnson syndrome. These patients are likely to require repeat operations and suffer severe long-term complications related to the keratoprosthesis, though immunosuppressive therapy may delay and mitigate the adverse outcomes.