Innovation in Keratoprostheses: A Review of Modern Devices and Strategies for Preventing and Managing Complications.

Decades of research and innovation have led to the development of modern keratoprostheses (KPros) designed to replace the function of the native human cornea. The Boston Keratoprosthesis (B-KPro) Type I remains the most widely used KPro worldwide. Ongoing refinements and modified versions of the B-KPro, as well as novel, fully synthetic devices, aim to enhance durability and biocompatibility, reduce complications, and expand accessibility to KPros across the globe. Innovative strategies such as immunomodulatory therapies, improved biomaterials, and novel drug delivery systems have been explored to address challenges such as retroprosthetic membrane formation, glaucoma, and infectious complications. This review provides an overview of currently available and emerging KPro technology and innovative strategies for preventing and managing KPro-associated complications.