Aniridia and Boston KPro: Is It a Long-Term Option?

Purpose of Review: Aniridia is a complex ocular disorder that causes limbal stem cell deficiency determining progressive aniridic keratopathy and the loss of corneal transparency. Allogeneic limbal stem cell transplantation followed by penetrating keratoplasty can stabilize the ocular surface but requires prolonged systemic immunosuppression. The type-1 Boston Keratoprosthesis can be a valid alternative allowing faster visual recovery without the need for systemic immunosuppression. Recent Findings: Several studies have reported good visual outcomes and good retention rates for keratoprosthesis in aniridic patients. Nonetheless, concerns still exist regarding complications that might lead to irreversible loss of function, such as glaucoma progression or intraocular infection. Other complications include retroprosthetic membrane formation, hypotony, and device extrusion. The presence of macular pathology and prevalence of glaucoma are two factors that may affect final visual acuity outcomes in aniridic patients. Summary: Implantation of the type-1 Boston Keratoprosthesis for aniridic keratopathy has shown promising results. However, further studies are needed to provide more evidence regarding long-term survival and complications.