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Abstract #73379 Published in IGR 18-4

No light perception outcomes following Boston Keratoprosthesis type 1 surgery

PURPOSE: To determine the incidence rate, principal causes, and clinical course of eyes developing no light perception (NLP) visual acuity (VA) following Boston Keratoprosthesis (B-KPro) type 1 surgery. Secondary objectives include determining the incidence rate, relative risk (RR), and survival probability with respect to NLP acuity among eyes with congenital aniridia. DESIGN: Retrospective, interventional case series. SUBJECTS: All patients undergoing B-KPro type 1 surgery between Oct. 2008 and June 2016 by a single surgeon at CHUM - Hôpital Notre-Dame. METHODS: Records of patients having undergone B-KPro implantation were reviewed. Eyes with a final outcome of NLP acuity were further reviewed to determine best recorded post-operative VA, time to NLP onset, clinical course and principal cause. Descriptive statistics, incidence rates, Kaplan-Meier survival curves and the RR of NLP acuity among eyes with aniridia were determined. Statistical significance was defined as P<0.05. RESULTS: Records of 119 patients were included, with an average follow-up of 49.1 ± 26.8 months post-operatively. Nineteen eyes had a final outcome of NLP acuity, representing 16.0%. The incidence rate of NLP acuity was 0.04 cases per eye-year of follow-up. The most common principal causes were inoperable retinal detachment (N=7, 36.8%), terminal glaucoma (N=6, 31.6%) and carrier graft melt-related complications (N=5, 26.3%). The RR of developing NLP among eyes with aniridia was 3.04 (p=0.01). CONCLUSIONS: No light perception acuity is a devastating but uncommon outcome of B-KPro surgery. Patients with aniridia appear to be at increased risk. In spite of all available medical and surgical interventions, some eyes may still suffer this outcome.

Department of Ophthalmology, Centre. Electronic address: muzychuk@gmail.com.

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