Original StudyRETINAL DETACHMENT IN EYES WITH BOSTON TYPE 1 KERATOPROSTHESIS Surgical Techniques and Mid-Term OutcomesBonnet, Clémence MD*,†; Chehaibou, Ismael MD*,‡; McCannel, Colin A. MD*; McCannel, Tara A. MD, PhD*; Prasad, Pradeep S. MD*; Kreiger, Allan E. MD*; Schwartz, Steven D. MD*; Aldave, Anthony MD*; Hubschman, Jean-Pierre MD* Author Information *Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, California; †Ophthalmology Department, AP-HP, Hôpital Cochin, Université de Paris, Paris, France; and ‡Ophthalmology Department, AP-HP, Hôpital Lariboisière, Université de Paris, Paris, France. Reprint requests: Jean-Pierre Hubschman, MD, Professor of Ophthalmology, Retina Division, Stein Eye Institute, 100 Stein Plaza, UCLA, Los Angeles, CA 90095; e-mail: [email protected] Supported by an unrestricted grant from the Research to Prevent Blindness and the Hess fund, which had no role in the design or conduct of this research. None of the authors has any conflicting interests to disclose. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.retinajournal.com). Retina: May 2022 - Volume 42 - Issue 5 - p 957-966 doi: 10.1097/IAE.0000000000003389 Buy SDC Metrics AbstractIn Brief Purpose: To evaluate the mid-term outcomes of pars plana vitrectomy performed for retinal detachment (RD) repair after Boston Type 1 keratoprosthesis (KPro) implantation. Methods: Retrospective review of medical records of KPro implanted at the Stein Eye Institute presenting with RD and treated by pars plana vitrectomy. Functional success was defined as a postoperative visual acuity maintained within 2 Snellen lines of the corrected distance visual acuity measured before the development of the RD (baseline) and anatomical success as an attached retina after the pars plana vitrectomy. Kaplan–Meyer survival analyses were performed. Results: Among the 224 KPro performed, 28 (15.2%) RD were identified; of which, 21 (9.4%) were included. The mean follow-up was 42.5 ± 27.3 months. Vitreoretinal proliferation was present in 18 of 21 eyes (85.7%). Surgical techniques were adapted to the complex anterior segment anatomy of KPro eyes. Anatomical success was achieved in 18 of 21 eyes (85.7%). Functional success occurred in 17 of 21 eyes (81.0%), and 5 of 21 eyes (23.8%) reached 20/400 or better visual acuity at the final follow-up. The KPro was retained in 11 in 21 eyes (52.4%). The retention rate decreased from 94.7% at 1 year to 53.5% at 5 years. The most frequent complications were retroprosthetic membrane (47.6%) and corneal melt (23.8%). Conclusion: Modified pars plana vitrectomy techniques resulted in relatively good mid-term anatomical, functional, and retention rate outcomes, given the severity of RD at presentation and the numerous preoperative comorbidities of KPro eyes. Retinal detachment after Boston Type 1 keratoprosthesis is a serious condition. Despite the preoperative complexity of these cases, pars plana vitrectomy can be an effective approach leading to acceptable anatomical, functional, and Boston Type 1 keratoprosthesis retention outcomes.