Abstract

Background: Potential vision rehabilitation in patients with hypotony and pre-phthisis remains one of the most challenging issues of ophthalmology. Boston type I keratoprosthesis (KPro) combined with pars plana vitrectomy (PPV) and silicone oil injection (SOI) represents a potential approach to this problem in patients believed to have recoverable vision. This study presents a case series of three patients who underwent Boston type I KPro implantation with simultaneous silicone oil tamponade at our center. Methods: We retrospectively reviewed medical records of three patients with prephthisical changes who underwent Boston type I KPro and PPV/SOI. Preoperative and postoperative visual acuity (VA), anatomical stability, and postoperative complications were assessed over a follow-up period. Three eyes of three patients were included. All eyes had severe corneal pathology with sufficient wet surface. Two of three eyes had corneal decompensation secondary to intraocular inflammation, one eye had penetrating trauma-related corneal scarring. All three eyes underwent simultaneous KPro implantation with combined PPV/SOI. Results: Postoperatively, all eyes demonstrated improvement in best-corrected visual acuity (BCVA) from hand motion (HM) to 20/1000, with final BCVA ranging from counting fingers at 2 feet (CF2) to 20/150 and no evidence of progressive phthisical changes over a follow-up period of 23–66 months. Conclusions: Boston type I KPro implantation combined with PPV/SOI can be a viable approach for preserving anatomical integrity and improving visual function in patients with prephthisical eyes and perceived recoverable-vision potential.

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