Vitreoretinal Complications in Two Designs of Type 1 Keratoprosthesis

PURPOSE: To report the incidence and spectrum of vitreoretinal complications (VRCs) in consecutive patients implanted with 2 designs of type 1 keratoprosthesis (KPro). METHODS: Retrospective analysis of electronic medical records. Demographic and clinical data were collected from patients who developed VRCs. The main outcome measure was the proportion of VRCs and their management. RESULTS: Eighty-four eyes from 81 patients with KPro were analyzed (Boston = 28; Lucia = 56). VRCs occurred in 32 cases (38.10%). The mean age of patients with VRCs was 55.15 ± 16.67 years (range: 27-90), and the mean follow-up duration was 33.90 ± 16.31 months. The most frequent VRC was retroprosthetic membrane formation requiring pars plana vitrectomy (n = 10, 11.90%), followed by retinal detachment (n = 9, 10.71%), choroidal detachment (n = 8, 9.52%), endophthalmitis (n = 8, 9.52%), vitreous hemorrhage (n = 7, 8.33%), cystoid macular edema (n = 2, 2.38%), asteroid hyalosis (n = 1, 1.19%), epiretinal membrane (n = 1, 1.19%), macular atrophy (n = 1, 1.19%), and sterile vitritis (n = 1, 1.19%). The median best-corrected visual acuity (BCVA) achieved after KPro implantation was 0.6 LogMAR (IQR: 0.18-1.3); in contrast, the median BCVA after any VRC was 2.4 LogMAR (IQR: 0.58-2.7). In all cases (100%), VRCs led to a deterioration in BCVA. Anatomical failure occurred in 7 cases (21.88%) and functional failure in 20 cases (62.50%), after a mean duration of 8.83 months. CONCLUSIONS: VRCs occurred in 38.10% of cases after type 1 KPro implantation and were associated with poorer outcomes, including increased anatomical and functional failure.