Expanding application of the Boston type I keratoprosthesis due to advances in design and improved post-operative therapeutic strategies.

PURPOSE: To evaluate how the advances in design of the Boston type I keratoprosthesis and in the treatment strategies to conquer the post operative complications have expanded the indications and application of this technology.
METHODS: A review and analysis of the keratoprosthesis literature specifically examining design modifications, treatment of post operative complications, and patient selection was performed.
RESULTS: Over the past two decades, many modifications to the design of the Boston type I keratoprosthesis and treatment of the patient in the post operative period have occurred. Also, the technology has been more widely accepted as a primary surgical option for patients with a poor preoperative prognosis for traditional penetrating keratoplasty. The outcomes of visual acuity, retention, and post-operative infection rates have all significantly improved since the technology has been modified and offers patients an alternative for visual rehabilitation.
CONCLUSIONS: Thanks to advances in design and perioperative care, the boston type i keratoprosthesis can now be considered a viable option for surgical visual rehabilitation in many patients with corneal pathology, and in certain groups the primary surgical procedure of choice.