The use of a modified full-thickness graft flap following Boston type I keratoprosthesis implantation in patients with advanced corneal melting.

PURPOSE: To evaluate a modified full-thickness corneal graft technique as a remedial strategy for advanced corneal melting following Boston type I keratoprosthesis (KPro) implantation.

METHODS

Eleven patients with significant corneal melting and >180° KPro exposure underwent corrective surgery. A donor graft, matching the primary transplant diameter and with a 3-mm central aperture, was thinned circumferentially and positioned beneath the KPro optical cylinder after debridement of necrotic tissue.

RESULTS

Over 6-12 months of follow-up, globe integrity was preserved in all cases. Two patients required repeat procedures for recurrence. Visual acuity improved in five patients; in others, it remained stable or declined due to comorbidities.

CONCLUSION

The modified full-thickness graft technique is a promising alternative for managing advanced corneal melting after Boston type I KPro. Further studies with larger cohorts and longer follow-up are warranted.