Boston Keratoprosthesis (KPro)
Synthetic cornea for end-stage corneal disease unsuitable for keratoplasty
This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.
This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göz Hastalıkları department. Book Appointment →
What is Boston Keratoprosthesis (KPro)?
The Boston keratoprosthesis (KPro) was developed by Dr. Claes Dohlman and is the most widely implanted synthetic cornea worldwide. The device consists of a clear polymethyl methacrylate (PMMA) front plate, a donor corneal carrier (allograft) with central trephination, and a titanium or PMMA back plate with holes for nutrition; the assembly is sutured to the host cornea like a keratoplasty.
Two designs exist: KPro Type 1 for patients with adequate tear production and lid function (most patients), and KPro Type 2 for severe end-stage ocular surface disease with cicatricial conditions and minimal tears, which requires permanent tarsorrhaphy with the device protruding through the lid. Type 1 has dramatically improved survival rates with vapor-deposited titanium back plates and rigid bandage contact lenses replacing prior PMMA designs.
Indications include multiple penetrating keratoplasty failures (gold standard indication), severe limbal stem cell deficiency without donor tissue, severe chemical or thermal burns, ocular cicatricial pemphigoid, Stevens-Johnson syndrome (Type 2), and aniridic keratopathy. Visual outcomes are excellent with 60-80% achieving 20/200 or better. Long-term complications include retroprosthetic membrane (most common), glaucoma (often progressive), endophthalmitis, sterile keratolysis, and device extrusion. Lifelong topical antibiotics, glaucoma surveillance, and bandage contact lens use are essential.
Symptoms
Risk Factors
When to See a Doctor?
If you experience any of the following symptoms, seek medical attention promptly:
- Multiple penetrating keratoplasty failures
- Severe limbal stem cell deficiency unresponsive to stem cell transplant
- Severe Stevens-Johnson syndrome with corneal blindness
- Ocular cicatricial pemphigoid with corneal failure
- Severe chemical or thermal burn with corneal blindness
- Aniridic keratopathy
- Bilateral corneal blindness
- Vascularized scarred cornea
- Inability to undergo or maintain conventional keratoplasty
- Failed scleral lens or other surface management
- Quality-of-life impairment from corneal blindness
- Light perception or hand motion vision
- Patient willing for intensive postoperative care
Treatment Methods
Which Department to Visit?
You can visit our Göz Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.
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You can make an appointment with our specialists or contact us for your concerns.
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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.