{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:18:53Z","timestamp":1787750333706,"version":"build-2784847793"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To assess 12-month visual acuity, anatomic integrity, and complication rates after Boston Type I Keratoprosthesis (BKPro-I) implantation in eyes with multiple failed penetrating keratoplasties and complex anterior segment pathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this prospective case series, four eyes (mean age, 32 \u00b1 9 years) received BKPro-I between January and June 2022. All surgeries employed polymethylmethacrylate front plates, customized titanium back plates, and a standardized perioperative regimen (IV cefazolin, topical vancomycin + levofloxacin, corticosteroid taper, nightly povidone-iodine, selective antifungal prophylaxis) with early 16 mm scleral lens fitting. Follow-up occurred at 3 days, 1 week, 2 weeks, monthly to 3 months, then quarterly to 12 months postoperatively. Primary outcomes were best-corrected visual acuity (BCVA), device retention, and sight-threatening complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>At 12 months, all devices were retained. Functional success (BCVA \u226520\/200) was achieved in 100% of eyes in 6 months; at 12 months, 75% reached \u226520\/100 and 50% \u226520\/60 (mean gain \u22655 ETDRS lines). Two eyes (50%) developed complications \u2013 retroprosthetic membranes, vitritis\/suspected endophthalmitis, stromal melting, chronic hypotony, and silicone-oil leak \u2013 all managed without device loss; one eye\u2019s vision declined to finger counting at month 7 but remained ambulatory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>BKPro-I yields excellent short-term visual rehabilitation and perfect retention in highly complex eyes. However, a 50% complication rate mandates rigorous patient selection, standardized perioperative protocols, and lifelong multidisciplinary follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/joco.joco_204_25","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:00:54Z","timestamp":1782126054000},"page":"455-461","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Twelve-Month Visual and Anatomical Outcomes of Boston Type I Keratoprosthesis in Four Patients with Multiple Graft Failures and Severe Ocular Pathology"],"prefix":"10.4103","volume":"37","author":[{"given":"Hamed","family":"Ghasemi","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pirouzeh","family":"Farsi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amirsadra","family":"Zangouei","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Hashemi","sequence":"additional","affiliation":[{"name":"Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"R1-20260623","doi-asserted-by":"crossref","first-page":"e1221","DOI":"10.1016\/S2214-109X(17)30393-5","article-title":"Global causes of blindness and distance vision impairment 1990-2020: A systematic review and meta-analysis","volume":"5","author":"Flaxman","year":"2017","journal-title":"Lancet Glob Health"},{"key":"R2-20260623","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.2147\/OPTH.S219270","article-title":"Boston type 1 keratoprosthesis: Updated perspectives","volume":"14","author":"Nonpassopon","year":"2020","journal-title":"Clin Ophthalmol"},{"key":"R3-20260623","first-page":"437","article-title":"Boston type 1 keratoprosthesis from patient selection through postoperative management: A review for the keratoprosthetic surgeon","volume":"10","author":"Williamson","year":"2016","journal-title":"Clin Ophthalmol"},{"key":"R4-20260623","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1016\/j.survophthal.2022.01.005","article-title":"The historical development and an overview of contemporary keratoprostheses","volume":"67","author":"Moshirfar","year":"2022","journal-title":"Surv Ophthalmol"},{"key":"R5-20260623","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1016\/j.ophtha.2008.12.058","article-title":"The Boston type I keratoprosthesis: Improving outcomes and expanding indications","volume":"116","author":"Aldave","year":"2009","journal-title":"Ophthalmology"},{"key":"R6-20260623","doi-asserted-by":"crossref","first-page":"620","DOI":"10.4103\/ijo.IJO_22_18","article-title":"Keratoprosthesis: Current global scenario and a broad Indian perspective","volume":"66","author":"Iyer","year":"2018","journal-title":"Indian J Ophthalmol"},{"key":"R7-20260623","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1097\/ICO.0000000000000886","article-title":"Boston type 1 keratoprosthesis: Visual outcomes, device retention, and complications","volume":"35","author":"Goins","year":"2016","journal-title":"Cornea"},{"key":"R8-20260623","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.ajo.2015.10.023","article-title":"Boston Type 1 Keratoprosthesis Study Group. Visual acuity outcomes of the Boston keratoprosthesis type 1: Multicenter study results","volume":"162","author":"Rudnisky","year":"2016","journal-title":"Am J Ophthalmol"},{"key":"R9-20260623","doi-asserted-by":"crossref","first-page":"1","DOI":"10.21037\/aes-22-67","article-title":"Boston type I keratoprosthesis","volume":"9","author":"Hu","year":"2024","journal-title":"Ann Eye Sci"},{"key":"R10-20260623","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.1016\/j.ophtha.2012.02.015","article-title":"International results with the Boston type I keratoprosthesis","volume":"119","author":"Aldave","year":"2012","journal-title":"Ophthalmology"},{"key":"R11-20260623","doi-asserted-by":"crossref","first-page":"975","DOI":"10.3390\/jcm13040975","article-title":"Outcomes of Boston keratoprosthesis type I implantation in Poland: A retrospective study on 118 patients","volume":"13","author":"Wr\u00f3blewska-Czajka","year":"2024","journal-title":"J Clin Med"},{"key":"R12-20260623","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.jcjo.2017.10.021","article-title":"Boston Type 1 Keratoprosthesis Study Group. Outcomes of Boston keratoprosthesis type 1 reimplantation: Multicentre study results","volume":"53","author":"Wang","year":"2018","journal-title":"Can J Ophthalmol"},{"key":"R13-20260623","doi-asserted-by":"crossref","first-page":"101919","DOI":"10.1016\/j.ajoc.2023.101919","article-title":"Use of PROSE for long-term ocular surface support in patients with a permanent keratoprosthesis","volume":"32","author":"Asghari","year":"2023","journal-title":"Am J Ophthalmol Case Rep"},{"key":"R14-20260623","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1136\/bjophthalmol-2014-306396","article-title":"Protective effect of soft contact lenses after Boston keratoprosthesis","volume":"100","author":"Kammerdiener","year":"2016","journal-title":"Br J Ophthalmol"},{"key":"R15-20260623","doi-asserted-by":"crossref","first-page":"e546","DOI":"10.1111\/aos.12309","article-title":"Infectious endophthalmitis in Boston keratoprosthesis: Incidence and prevention","volume":"92","author":"Behlau","year":"2014","journal-title":"Acta Ophthalmol"},{"key":"R16-20260623","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1097\/ICO.0000000000002098","article-title":"Systematic review and meta-analysis of the medium- and long-term outcomes of the Boston type 1 keratoprosthesis","volume":"38","author":"Priddy","year":"2019","journal-title":"Cornea"},{"key":"R17-20260623","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/ICO.0000000000001412","article-title":"Intermediate-term and long-term outcomes with the Boston type 1 keratoprosthesis in Aniridia","volume":"37","author":"Shah","year":"2018","journal-title":"Cornea"},{"key":"R18-20260623","doi-asserted-by":"crossref","first-page":"2561","DOI":"10.1007\/s00417-024-06445-6","article-title":"Incidence, risk factors, and treatment of retroprosthetic membranes following Boston keratoprosthesis eyes and the impact of glaucoma surgery","volume":"262","author":"Gabriel","year":"2024","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"R20-20260623","first-page":"33","article-title":"Management of corneal melting after keratoprosthesis: A case report highlighting successful corneal patch graft and review of management strategies","volume":"7","author":"Arzaghi","year":"2023","journal-title":"J Ophthalmic Optom Sci"},{"key":"R21-20260623","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1080\/09273948.2016.1269930","article-title":"Corneal melt after Boston keratoprosthesis: Clinical presentation, management, outcomes and risk factor analysis","volume":"26","author":"Bouhout","year":"2018","journal-title":"Ocul Immunol Inflamm"},{"key":"R22-20260623","first-page":"137","article-title":"Management of glaucoma with Boston type 1 keratoprosthesis","volume":"86","author":"Utine","year":"2023","journal-title":"Arq Bras Oftalmol"},{"key":"R23-20260623","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1016\/j.ophtha.2010.12.032","article-title":"Longer-term vision outcomes and complications with the Boston type 1 keratoprosthesis at the University of California, Davis","volume":"118","author":"Greiner","year":"2011","journal-title":"Ophthalmology"},{"key":"R24-20260623","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.ajo.2012.03.001","article-title":"Chronic hypotony associated with the Boston type 1 keratoprosthesis","volume":"154","author":"Dokey","year":"2012","journal-title":"Am J Ophthalmol"},{"key":"R25-20260623","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.ajo.2011.07.022","article-title":"Prevalence, progression, and impact of glaucoma on vision after Boston type 1 keratoprosthesis surgery","volume":"153","author":"Talajic","year":"2012","journal-title":"Am J Ophthalmol"}],"container-title":["Journal of Current Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/joco.joco_204_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T12:25:30Z","timestamp":1787747130000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/joco.joco_204_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":24,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/joco.joco_204_25","relation":{},"ISSN":["2452-2325"],"issn-type":[{"value":"2452-2325","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-07-28","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-17","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}