The Boston keratoprosthesis (KPro) is a widely used type of artificial cornea designed to restore vision in eyes with severe corneal disease and poor prognosis for standard grafts. It uses a central PMMA optic assembled with donor corneal tissue.
Design and Surgery
The device consists of front and back plates that clamp a donor corneal button, which is then sutured into the host cornea like a penetrating graft. A bandage contact lens is worn long term to protect the surface and maintain hydration.
- Available in aphakic and pseudophakic designs
- Requires lifelong prophylactic antibiotics and frequent follow‑up
- Often combined with glaucoma monitoring devices or surgery
- Surgery is performed only in specialised centres with experience in KPro care
Outcomes and Risks
Many patients achieve substantial visual improvement, sometimes to reading levels, but complications are common over time. These include glaucoma progression, retroprosthetic membrane formation, infection, and retinal detachment.
- Regular imaging and pressure assessment are crucial
- Secondary procedures such as membrane peeling or retinal surgery may be needed
- Failure can require device exchange or removal
- Patient commitment to intensive long‑term care strongly influences success
