Results of Lucia Keratoprosthesis Implantation in Severe Corneal Disease

• Published in: American journal of ophthalmology Vol. 268; pp. 388 - 394
• Main Authors: Ortiz-Morales, Gustavo, Vera-Duarte, Guillermo Raul, Jimenez-Collado, David, Rivera, Jose Arteaga, Rivera, Karla Arteaga, Domene-Hickman, Jorge Luis, Müller-Morales, Carlos Adolfo, Navas, Alejandro, Ramirez-Miranda, Arturo, Chodosh, James, Graue-Hernandez, Enrique O.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-12-2024
• ISSN: 0002-9394; 1879-1891; 1879-1891
• DOI: 10.1016/j.ajo.2024.08.035

•The Lucia KPro is a novel iteration of the Boston KPro.•Lucia KPro aims to improve affordability and appearance for use in low-resource settings.•Previous glaucoma and retinal disease are associated to functional failure.•Lucia KPro showed a 95.83% retention rate and 62.5% BCVA ≥20/200 at the last follow-up.
Describe complications, functional success, and retention of the Lucia Keratoprosthesis (KPro).
Retrospective interventional case series
The demographic data, baseline characteristics, complications, functional success, and retention were analyzed for Lucia KPro at the Instituto de Oftalmologia Conde de Valenciana in Mexico City from 2021 to 2023. Multivariate regression analysis and Kaplan-Meier plots were performed to identify associations with functional failure. The main outcome measures were postoperative complications, functional success defined as best-corrected visual acuity (BCVA) ≥20/200 (logMAR 1.0), and device retention rate.
Forty-eight eyes of 48 patients (56.88% male) were studied. The mean age at implantation was 57.29 ± 15.63 years (range 27-91), with a mean follow-up of 20.5 ± 8.83 months (range 3-40). Diagnostic indications for implantation included recurrent graft rejection (54.17%), autoimmune disease (20.83%), chemical injury (12.5%), and other (12.5%). At least 1 postoperative complication occurred in 75% of patients, leading to 65 additional interventions (mean number of subsequent procedures: 1.35 ± 1.3, range 0-5). The preoperative BCVA was 2.40 ± 0.36 logMAR. At the final follow-up, 62.5% had achieved functional success and 22.92% had a BCVA of 20/40 (logMAR 0.3) or better. Glaucoma (adjusted OR 469.74, 95% CI 5.02-43939.14, P = .007) and retinal pathology before KPro (adjusted OR 372.38, 95% CI 4.18-33162.11, P = .009) were associated with functional failure. The device remained in place in 95.83% of recipients over the follow-up period.
The Lucia KPro offers functional success in severe corneal diseases and excellent retention in the short to intermediate term.