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Boston Keratoprosthesis

Boston Keratoprosthesis

Artificial Cornea

Introduction:

The BKPro is an artificial cornea designed to replace the damaged or scarred corneal tissue in individuals with severe corneal disease. It consists of a front optical portion, which acts as a clear window for vision, and a back plate that secures the device within the eye. There are 2 main types of BKpro devices. 

1. Type I (Standard):

   - This is the original and most commonly used type of BKPro.

   - It consists of a front optical portion made of clear plastic (PMMA) and a back plate to hold it in place within the eye.

   - The Type I BKPro is suitable for patients with normal or near-normal eyelid function.

 

2. Type II (Boston KPro Type II):

   - This type is designed for patients with compromised eyelid function or severe ocular surface disease.

   - It includes a front optical portion like the type 1 but with an extension which protrudes through the eyelid skin or a mucosal graft. The back plate secures the front part on donor carrier. 

Each type of Boston Keratoprosthesis offers unique advantages and may be better suited to certain patients depending on factors such as eyelid function, ocular surface condition, and risk of complications. Ophthalmologists will carefully assess each patient's individual needs and anatomy to determine the most appropriate type of BKPro for their situation.

 

Purpose:

The primary purpose of the BKPro is to improve vision and alleviate symptoms associated with corneal disease, such as blurred vision, pain, and discomfort. It serves as a durable and stable solution for patients who have not achieved satisfactory outcomes with traditional treatments, such as corneal transplantation.

 

Procedure:

The surgery to implant the BKPro involves several steps:

1. Pre-operative Evaluation: Before surgery, your ophthalmologist will conduct a thorough evaluation of your eyes to assess your candidacy for the BKPro and plan the surgical approach.

2. Anesthesia: The procedure is typically performed under local or general anesthesia to ensure your comfort.

3. Corneal Removal: The diseased or scarred cornea is carefully removed to make way for the BKPro.

4. BKPro Implantation: The BKPro device is placed into the eye and secured in position with sutures.

5. Post-operative Care: Following surgery, you will require close monitoring and a regimen of eye drops and medications to prevent infection and promote healing.

 

Candidates:

Candidates for the BKPro include individuals with severe corneal disease who have not responded to other treatments, such as:

- Corneal scarring from infections, trauma, or chemical burns

- Autoimmune diseases affecting the cornea, such as Stevens-Johnson syndrome or ocular cicatricial pemphigoid

- Multiple failed corneal transplants

 

Benefits:

The BKPro offers several benefits to patients, including:

- Improved vision: Many patients experience significant improvements in vision following BKPro implantation.

- Enhanced comfort: The BKPro can alleviate symptoms such as pain, discomfort, and light sensitivity associated with corneal disease.

- Long-term solution: With proper care and monitoring, the BKPro can provide a stable and durable solution for vision loss due to corneal disease.

 

Risks:

While the BKPro can offer significant benefits, it is essential to be aware of the potential risks, including:

- Infection: There is a risk of developing an infection following BKPro surgery, which can be serious and require prompt treatment.

- Glaucoma: Some patients may develop increased pressure within the eye (glaucoma) following BKPro implantation, requiring ongoing monitoring and management.

- Retinal detachment: In rare cases, the BKPro surgery may increase the risk of retinal detachment, a potentially sight-threatening complication.

 

Post-operative Care:

Following BKPro surgery, you will need to adhere to a strict regimen of eye drops and medications to prevent infection and promote healing. Your ophthalmologist will schedule regular follow-up appointments to monitor your progress and ensure the health of your eye and the function of the BKPro.

 

Conclusion:

The Boston Keratoprosthesis (BKPro) is a revolutionary treatment option for individuals with severe corneal disease. By replacing damaged or scarred corneal tissue with an artificial cornea, the BKPro can restore vision and improve quality of life for patients who have exhausted traditional treatment options. If you believe you may be a candidate for the BKPro, consult with your ophthalmologist to discuss the benefits, risks, and expectations associated with the procedure.

One eyed patient, Boston Type 1 Kpro performed in 2011, 8 years follow up.. maintaining vision of 6/12.

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