Boston Type 1 Keratoprosthesis Implantation in Traumatic Stem Cell Deficiency and Keratoplasty Rejection

A 31-year-old male patient was admitted with the complaint of decreased vision in both eyes. He underwent multiple pars plana vitrectomy and silicone oil injection operations due to bilateral retina detachment after rocket projectile explosion in his hands at the age of 15. The right eye was pre-phthisical after choroidal hemorrhage that occurred during combined silicone oil extraction and penetrating keratoplasty. The aphakic and vitrectomized left eye had corneal conjunctivalisation of seven dials, deep and superficial stromal neovascularization and history of immunological graft rejection. As the estimated success rate for repeat penetrating keratoplasty was low, Boston type 1 keratoprosthesis surgery was performed. Postoperatively, visual acuity was 0.2 Snellen lines. Macular scar and optic nerve atrophy limited further visual gain. In this study, we aimed to review the current literature about Boston type keratoprosthesis surgery, which should be evaluated as an alternative when conventional penetrating keratoplasty success is deemed to be low.