Z HOT TOPIC Z 

Authors: Taylor Nayman, Cristina Bostan, Andrei-Alexandru Szigiato, Mona H. Dagher
Author Disclosure Block: T. Nayman: None. C. Bostan: None. A. Szigiato: None. M. H. Dagher: None.

Abstract Body:

Purpose: To compare long-term outcomes of primary vs. secondary (post-graft failure) Boston Keratoprosthesis type 1 (KPro).
Study Design: Retrospective comparative cohort study.
Methods: A retrospective comparative cohort study was performed on 82 eyes with reversible corneal blindness. All eyes had no prior retinal disease or glaucoma that could compromise post-operative visual potential. All received a KPro type 1 (40 primary vs. 42 secondary KPro) by a single surgeon with a minimum of five years of follow-up. Outcomes included visual acuity (VA), complications, and device retention. A statistical analysis compared the primary vs. secondary KPro groups to evaluate differences between outcomes.
Results: Mean follow-up was 59.6 ±2.3 months. VA increased from baseline in both groups at all time points. In both groups this was significant for the first 3 years post-operatively (p<0.05), and years 4 and 5 in the primary group (p<0.05) but not in the secondary group. VA was similar between groups at each time point up to 5 years (logMAR VA 1.3±0.8 in primary vs. 1.5 ±0.8 in secondary at 5 years, p>0.05). Sterile vitritis, choroidal detachment, and glaucoma occurred more frequently after primary KPro (17.5% vs. 2.4%, 27.5% vs. 7.14%, and 35% vs. 14% respectively, p<0.05). Primary KPro had lower retention rates (70.0% vs. 90.5%, p<0.05).
Conclusions: Primary KPro yielded similar visual outcomes to secondary KPro long-term but showed higher complication and lower retention rates, which differs from published short-term results. However, for patients for whom a traditional graft is likely to fail, a KPro represents a feasible and promising option.