Clinical features and prognosis of boston type I keratoprosthesis- associated corneal melt

Purpose: To describe the clinical features and outcomes of corneal melt associated with Boston type I keratoprosthesis (KPro) implantation. Methods: Medical records of patients who experienced corneal melt following KPro implantation were reviewed retrospectively. Results: Sixty-six adult patients had KPro implantation from January 2004 to November 2010. Six patients had an underlying inflammatory ocular surface disorder. Four experienced corneal melt (6.1%) 542 months after the initial surgery. One patient was diagnosed with Sjögren's syndrome as a result of diagnostic workup following melt. Three patients were treated with systemic immunomodulatory therapy; two experienced fungal keratitis and subsequent endophthalmitis. KPro had to be explanted and replaced with donor cornea in all cases. Conclusions: KPro-associated corneal melt is uncommon and appears to occur in patients with preexisting inflammatory disorders, which might not have been previously diagnosed. Timely explantation of KPro and replacement with donor cornea may prevent a poor outcome.