Purpose: Considering the fact that complications following type I Boston keratoprosthesis (KPro) occur after months, we examined the long term visual and anatomical prognosis of patients who require KPro reimplantation. Our hypothesis is that a new KPro following the failure of the first one could offer a good visual and anatomical prognosis.

Methods:
This study is a descriptive, retrospective chart review of patients receiving a KPro at the University of Montreal Hospital Center between July 2008 and July 2018. Adult patients who required a KPro reimplantation were included in this study. Baseline characteristics including the indication of the original surgery, cause of initial KPro failure, visual acuity and complication rate were retrieved. Our primary endpoints were the prosthesis retention, the number of patients with a final visual acuity superior to 20/200 and with no light perception. Secondary endpoints include postoperative complications rate.

Results:
17 of the 141 eyes operated in our center required a KPro reimplantation. Corneal melt was the most common indication for reimplantation (88%). Mean follow-up time after the second KPro was 3,6 ± 2,6 years. Overall retention rate of the second prosthesis was 94%. At 6 months and 1 year, 47% of patients retained a vision better than 20/200. Final visual acuity > 20/200 was found in 35% of the patients. Loss of light perception was found in 35% of the eyes (n=6) which was secondary to an inoperable retinal detachment in 4 cases. Retroprosthetic membrane formation (53%) was the most common complication. Two patients developed phthisis following a large inoperable retinal detachment. 

Conclusion:

This study offers the longest post-operative follow-up after a Boston keratoprosthesis reimplantation in the literature. In our cohort, prosthesis retention was excellent. However, visual acuity was severely affected mostly due to severe posterior segment disease or terminal glaucoma.

The long-term prognosis of Type I Boston Keratoprosthesis reimplantation

[Poster Abstract Booklet](https://drive.google.com/file/d/1AGitRGyG9W0FiZ2Xjz6RNO2h7C0XglOL/view)

[Surgical Video Abstract Booklet](https://drive.google.com/file/d/1B-IkojrZhXk4AgXzsEQyuE_FwPG1Lvpe/view?usp=sharing)

[To claim Section 2 credits for ePoster review complete this Poster Transcript](https://drive.google.com/open?id=1dSAjpIIqFqD4SUbpcc6-PzX65ZPFhA7O)