Retroprosthetic Membrane Formation After Boston Keratoprosthesis: Is It Truly a Benign Complication?

Abstract Purpose of Review Advances in Boston type 1 keratoprosthesis (K-Pro) technology and postoperative management have led to a decrease in postoperative complications and expanded indications in recent years. However, several challenges still remain, including the post-implantation development of fibrous tissue behind the device known as a retroprosthetic membrane (RPM). Herein, we review the epidemiology, pathophysiology, detection, treatment, prevention, and sequelae of RPM formation after keratoprosthesis implantation. Recent Findings Among postulated risk factors, device indication has been found to be a significant predictor of RPM formation. However, the etiology is likely multifactorial and probably involves both pathologic wound healing triggered by the device and host-specific factors. Anterior segment optical coherence tomography is emerging as a useful tool in the detection and monitoring of RPM formation. Once diagnosed, most RPMs affecting vision are responsive to therapy. However, attempts to reduce the burden of RPM formation including the utility of intracameral corticosteroid prophylaxis at the time of surgery have shown limited effect. Beyond visual impairment, evidence suggests that membrane extension behind the back-plate and into local intraocular structures may contribute to significant morbidity. Indeed, recent re...
Source: Current Ophthalmology Reports - Category: Opthalmology Source Type: research