A Boston Keratoprosthesis (Boston KPro) is an artificial cornea. “Artificial cornea” means a clear, man-made window that a surgeon places in the front of the eye to let light enter again when the natural cornea is badly scarred, cloudy, or keeps rejecting grafts. The device has three main parts: a front plate with a clear optical stem (the tiny “window” you look through), a back plate that sits behind a donated corneal “carrier,” and a small locking ring that holds everything tightly together. The unit is implanted into a circle of donor corneal tissue and then sewn into the patient’s cornea like a full-thickness corneal transplant. In short, it replaces the cloudy window with a permanent, clear window.
The Boston Keratoprosthesis (often called Boston KPro) is an “artificial cornea.” Surgeons use it to restore sight when regular corneal transplants have failed or are very unlikely to work—such as in eyes with multiple graft failures, severe scarring, or intense blood vessel growth on the cornea. The device has a front clear lens and a back plate that sandwich a thin donor corneal disc; a tiny central “stem” connects them (think of a collar-button). Light passes through the clear plastic cylinder to the inside of the eye, just like a window. Modern models use a titanium back plate (safer and more biocompatible) and a clear plastic front piece (PMMA) for optics. Review of Ophthalmologyengage.england.nhs.ukAAO Journal
A regular corneal transplant (called penetrating keratoplasty) works well for many people. But some eyes have very high risk of graft failure—because of severe scarring, dry eye, immune problems, surface disease, or many failed grafts in the past. In those hard cases, a Boston KPro may be safer and more durable than repeating transplant surgery. It is not a first-line surgery; it is a rescue option for difficult, end-stage corneal disease when standard grafts are unlikely to survive.
How it works—short, plain explanation
Light must pass through a clear cornea to reach the retina. When the cornea is opaque, the world looks foggy or black. The Boston KPro puts a crystal-clear cylinder through the opaque cornea so light reaches the retina again. The donor corneal “carrier” provides living tissue around the device so the eye can be sewn closed and remain watertight. After surgery, patients usually wear a soft bandage contact lens long-term to keep the surface moist. People also use lifelong topical antibiotics and anti-inflammatory drops and need regular follow-up to watch for glaucoma, membrane growth, infection, or melting of tissue.
Types of Boston Keratoprosthesis
Type I (the commonest type)
What it is: Type I sits under the eyelids, just like a normal cornea. The front “window” is flush with the surface.
Who it’s for: Eyes that have poor corneal clarity but reasonable eyelids, tear film, and blinking. Examples: multiple failed grafts, extensive corneal scarring, or high-risk vascularized corneas.
Daily life notes: A bandage contact lens is worn full time to protect the surface and keep it moist. Patients use daily antibiotic drops and anti-inflammatory drops and come for regular pressure checks and imaging.
Type II (for extreme surface disease)
What it is: Type II is for eyes with severely dry, scarred, or keratinized ocular surfaces—for example, after Stevens–Johnson syndrome or ocular cicatricial pemphigoid. The device’s optical cylinder protrudes through surgically closed eyelids (a permanent near-complete tarsorrhaphy), so the “window” stays visible even though the lids are closed.
Who it’s for: Extreme dryness and scarring where a soft contact lens cannot be worn and standard corneal surgery would fail.
Daily life notes: Because the optic sticks out through the eyelid skin, surface moisture issues are reduced, but lid and skin care become important, and follow-up is still lifelong.
Common configurations you may hear about
Aphakic vs. pseudophakic KPro: “Aphakic” means the natural lens (and usually the lens capsule) is absent; the optical power of the KPro is chosen to focus the eye without a lens. “Pseudophakic” means a plastic intraocular lens is already in place; the KPro optic is chosen to match it.
Back-plate materials: Modern devices often use a biocompatible back plate (commonly PMMA or titanium) designed to be inert and to reduce inflammation.
Combined surgery: Many eyes receive glaucoma drainage devices and/or vitrectomy at the same sitting to manage pressure and keep the back of the eye healthy.
Causes
These are conditions that damage the cornea or make standard corneal grafts fail, pushing surgeons to choose a KPro.
Multiple failed corneal grafts: When several transplants have rejected or failed, the chance of another success becomes low. A KPro can bypass that cycle.
Severe alkali chemical burns: Alkali injuries melt and scar the cornea and destroy stem cells, making regular grafts very risky.
Severe acid chemical burns: Acids scar the cornea and conjunctiva; if damage is deep, a KPro may be the better option.
Stevens–Johnson syndrome / toxic epidermal necrolysis: This immune reaction scars eyelids and ocular surface, causing dryness and keratinization; KPro Type II is often considered.
Ocular cicatricial pemphigoid (mucous membrane pemphigoid): Autoimmune scarring disease that shrinks conjunctiva and damages the surface; standard grafts rarely survive.
Aniridia-related keratopathy: In some people born without an iris, the corneal surface fails over time; a KPro may restore vision.
Limbal stem cell deficiency (any cause): When corneal stem cells are lost (from burns, long-term contact lens abuse, or surgeries), the surface grows skin-like tissue; KPro can bypass this.
Herpes simplex keratitis scarring: Repeated viral ulcers can leave dense scars; if grafts fail, KPro becomes an option once infection is quiet.
Herpes zoster (shingles) keratopathy: Nerve damage and inflammation cause scarring and neurotrophic ulcers; KPro may help in end-stage cases.
Acanthamoeba keratitis scarring: This difficult infection can leave severe scarring and pain; after cure, KPro may restore clarity.
Severe fungal keratitis scarring: Deep, destructive infections often end with opaque corneas; KPro can offer vision when grafts are high-risk.
Trachoma scarring: Long-standing infection can scar lids and cornea; advanced cases may need KPro.
Autoimmune peripheral ulcerative keratitis (e.g., rheumatoid): When the cornea melts and vascularizes, grafts fail easily; KPro can be considered once inflammation is controlled.
Radiation-induced keratopathy and dryness: After cancer treatment, severe dry eye and scarring may make KPro the best option.
Neurotrophic keratopathy: Loss of corneal sensation (e.g., after surgery, diabetes, or tumors) causes non-healing defects; KPro may be used in advanced disease.
Severe ocular surface burns from explosion or heat: Thermal injuries can destroy the ocular surface; KPro may restore some vision.
Post-perforation scarring: After a corneal perforation heals with dense scar, KPro may provide a clearer visual axis than a risky graft.
Post-inflammatory vascularized scars (any cause): Dense blood vessels raise rejection risk; KPro avoids immune rejection of a living graft.
Congenital corneal opacities (selected cases): In rare, difficult pediatric cases after other options fail, a KPro may be chosen by expert centers.
Corneal dystrophies with repeated graft failure (e.g., aggressive lattice): If multiple grafts fail, KPro is sometimes the fallback solution.
Symptoms
“Symptoms” here means what the patient feels or notices. Some are before surgery (from the underlying disease); some are warning signs after surgery that need urgent care.
Very blurry or blocked vision: Everything looks hazy or dark because the cornea is no longer clear.
Severe light sensitivity (photophobia): Bright light hurts or forces the eye to close.
Eye pain or burning: From active inflammation, ulcers, or very dry surface.
Redness and irritation: Ongoing surface disease makes the eye look red and feel gritty.
Tearing or thick discharge: A sign of surface damage or infection.
Recurrent surface scratches (erosions): The cornea keeps breaking down, causing sharp pain and watering.
Foreign-body sensation: Constant feeling that something is in the eye.
Dryness and “sand in the eye” feeling: Especially in severe surface diseases like SJS or OCP.
Halos and glare: Light scatters in a scarred cornea, making night vision poor.
Trouble reading or recognizing faces: Loss of detail vision from central opacities.
Contact lens intolerance: The eye cannot tolerate lenses that might otherwise protect the surface.
Frequent infections or ulcers: Repeated episodes suggest high risk for graft failure.
Sudden sharp pain with more tearing: Could mean a corneal perforation or severe erosion—urgent.
Dull brow ache or headache: Can be a sign of high eye pressure (glaucoma), which must be watched closely before and after KPro.
After KPro—new floaters, flashing lights, curtain of darkness: Possible retinal detachment or infection—emergency evaluation needed.
Diagnostic tests
Doctors use these tests to decide if a KPro is right, to plan surgery, and to monitor the eye afterward. We group them as Physical exam, Manual tests, Lab/Pathology, Electrodiagnostic, and Imaging. The total is twenty tests.
A) Physical exam
Visual acuity (distance and near): Reading letters on the chart shows how much detail you can see now and helps set realistic goals for after surgery.
Refraction and pinhole test: Lenses and a pinhole check whether any blur is from focus problems or from corneal opacity; this helps predict potential vision.
Pupil exam and RAPD check: Swinging a light between eyes reveals a relative afferent pupillary defect (RAPD). A strong RAPD suggests optic nerve or retinal damage, which limits final vision even if the cornea is made clear.
Slit-lamp biomicroscopy: A microscope exam maps where the cornea is scarred, thinned, or vascularized, whether there are adhesions (synechiae), and if there is active inflammation or infection.
Eyelid and surface evaluation: Doctors look for trichiasis (lashes rubbing the eye), meibomian gland disease, symblepharon (scar bands), and keratinization. Good lids and tears favor Type I; severe scarring favors Type II.
B) Manual tests
Schirmer tear test: A small paper strip under the lower lid for five minutes measures tear production. Very low numbers mean a dry surface, pushing toward Type II or extra surface protection.
Fluorescein staining and TBUT (tear break-up time): A safe yellow dye highlights dry spots and scratches; the time until the first dry patch shows how stable your tears are.
Seidel test: The same dye checks for a leak from a thin or perforated cornea. A positive “green stream” means fluid is escaping—an urgent problem to fix before or during KPro.
Eye pressure by palpation or scleral tonometry: In very scarred corneas, standard pressure tools are inaccurate. Doctors gently palpate the globe or use a Tono-Pen on the white of the eye to estimate pressure, which is crucial because glaucoma can silently steal vision.
C) Lab and pathological tests
Conjunctival biopsy with direct immunofluorescence: A tiny tissue sample from the inner eyelid checks for ocular cicatricial pemphigoid (an autoimmune scarring disease). Proving this matters because it changes long-term management and the choice of KPro type.
Microbiology (culture and PCR) from corneal scrapings or surface swabs: Identifies bacteria, fungi, Acanthamoeba, or herpes viruses. A quiet, infection-free eye is safer for KPro.
Serum vitamin A level: Very low vitamin A can cause keratomalacia (corneal melting). Correcting this deficiency before surgery helps healing.
Tear osmolarity and MMP-9 testing: These point-of-care tests detect dry eye severity and inflammatory activity (MMP-9 is an enzyme linked to surface inflammation). They guide how aggressively to treat the surface pre-op.
D) Electrodiagnostic tests
Full-field electroretinography (ERG): Measures overall retinal function. If the retina responds poorly, even a clear cornea may not give good vision; surgeons discuss realistic expectations.
Visual evoked potentials (VEP): Records the brain’s response to visual signals. Weak or delayed signals suggest optic nerve or pathway damage, again shaping expectations.
Multifocal ERG: Maps function in the macula (the center of vision). This helps estimate potential reading vision after KPro.
E) Imaging tests
Anterior-segment optical coherence tomography (AS-OCT): A non-contact scan that shows corneal thickness, scarring depth, interface planes, and angle anatomy. It helps plan trephine size and detect thinning at risk of perforation.
B-scan ocular ultrasound: Sound waves “see” through an opaque cornea to check the vitreous and retina for detachment, scarring, or membranes—key information before KPro.
Ultrasound biomicroscopy (UBM): A high-frequency ultrasound that images the iris, ciliary body, and drainage angle. It helps plan glaucoma device placement and judge the risk of angle closure.
Macular and optic nerve OCT (when possible): If any view is available pre-op—or definitely after KPro—this scan measures macular layers and nerve fiber thickness, tracking edema or glaucoma progression over time.
Non-pharmacological treatments
Below are the hands-on or lifestyle pieces of care. Each includes what it is, why it’s done, and how it helps.
Lifelong bandage soft contact lens (BCL)
What: A soft lens worn continuously.
Purpose: Shields the donor corneal “gasket,” keeps it moist, lowers rubbing and infection risk.
How it helps: Reduces surface breakdown and sterile corneal melt around the device; lenses are cleaned/changed regularly by the clinic. Mass Eye and EarReview of Contact LensesRegular, scheduled follow-ups (initially day-1, 1 week, 1 month, then every 1–3 months)
Purpose: Early detection of RPM, infection, melt, glaucoma, or retinal problems.
How: Slit-lamp exam, optic nerve checks, wide-field imaging when possible. Mass Eye and EarMeticulous hand and lens hygiene
Purpose: Prevents microbes from reaching the graft and device edge.
How: Wash hands before drops or lens handling; never rinse lenses with water. CDCKeep water off lenses (no swimming, hot tubs, shower with eyes tightly closed or lenses out)
Purpose: Avoids Acanthamoeba and other water-borne infections.
Mechanism: Lenses can trap organisms against the eye. CDCPMCProtective eyewear & sleep shields
Purpose: Prevents accidental bumps and drying wind exposure, especially outdoors or at night.
How: Wrap-around glasses daytime; moisture chamber or shield at bedtime.Humidification & moisture goggles
Purpose: Adds humidity to reduce tear evaporation and edge dryness.
Mechanism: A moister micro-environment stabilizes the surface and lens.Lid hygiene & warm compresses
Purpose: Controls blepharitis/meibomian gland disease.
Mechanism: Better oil layer means steadier tear film over the graft/lens.Blink training and “screen breaks”
Purpose: Prevents exposure-related dryness in heavy device/computer users.
Mechanism: 20-20-20 rule; conscious complete blinks lubricate the lens-cornea interface.Strict drop technique
Purpose: Keeps bottles sterile, ensures correct dose.
How: Don’t touch tip to eye/lids or lens; cap immediately.AS-OCT imaging at intervals
Purpose: Maps the device-cornea interface, catches early melts and RPMs you can’t see well at the slit lamp.
Mechanism: Cross-sectional scans reveal gaps, thinning, or membranes early. SciELOUltrasound biomicroscopy (UBM) when needed
Purpose: Visualizes angle structures, tube shunts, and the area behind the back plate.
Mechanism: High-frequency ultrasound shows structures hidden by the prosthesis. EyeWikiSciELOB-scan ultrasound for posterior segment
Purpose: Looks for retinal detachment, vitreous hemorrhage, or choroidal issues when the view is limited.
Mechanism: Sound waves map the back of the eye. Review of OphthalmologyUltra-widefield fundus imaging when feasible
Purpose: Documents retina through the KPro for baseline and surveillance.
Mechanism: Scanning laser ophthalmoscopy reaches far peripheral retina. PubMedVisual field testing & optic nerve OCT/photos
Purpose: Monitors glaucoma, a top threat after KPro.
Mechanism: Structure-function tracking over time. Goldmann fields can be useful when automated fields are unreliable. Review of OphthalmologyEyeWikiIOP assessment alternatives & palpation
Purpose: Corneal tonometers don’t work on a prosthetic cornea.
Mechanism: Tactile (finger) IOP, scleral or trans-palpebral devices are sometimes used, but none is perfect; combine with nerve/OCT/fields. PMCSun/UV protection
Purpose: Comfort and surface protection; may reduce phototoxic stress.
Mechanism: Sunglasses and hats cut glare and drying wind.Smoking cessation
Purpose: Improves tissue healing; lowers infection risk.
Mechanism: Better microvascular health aids graft survival.Optimize systemic autoimmune disease control
Purpose: Conditions like OCP or SJS greatly raise complication risk.
Mechanism: Coordinated care with rheumatology reduces inflammation burden. EyeWikiClinic-performed contact lens exchanges
Purpose: Removes deposits/biofilm and checks fit; schedule commonly every 1–3 months.
Mechanism: Cleaner lens = fewer microbes and less friction. Review of Contact LensesClinic-pulsed antifungal surface sterilization in high-risk regions
Purpose: Limits fungal colonization on lens/ocular surface.
Mechanism: Brief clinic-directed pulses (e.g., povidone-iodine rinse or short antifungal bursts) where fungi are common. cdn.amegroups.cn
Core drug treatments
Important: Doses are typical examples; your cornea surgeon will individualize them. Some drugs are compounded.
Topical moxifloxacin 0.5% or gatifloxacin 0.5%
Dose/time: 4×/day for ~2 weeks after surgery, then once daily for life.
Purpose: Daily infection prevention (bacteria).
Mechanism: Broad-spectrum fluoroquinolone prophylaxis.
Side effects: Stinging, rare allergy, resistance over time. Mass Eye and EarTopical vancomycin 14 mg/mL (compounded, often with BAK 0.005%)
Dose: Once daily for life (some centers alternate with Polytrim after the early period).
Purpose: Extra coverage against gram-positive organisms (e.g., MRSA).
Mechanism: Cell wall inhibition; complements fluoroquinolone/Polytrim.
Side effects: Redness/irritation; access via compounding pharmacy. Mass Eye and EarPolymyxin B/trimethoprim (Polytrim) drops
Dose: Often once daily long-term (alternative to the fluoroquinolone + vancomycin pair after the early postop phase).
Purpose: Ongoing broad prophylaxis.
Mechanism: Two antibiotics with different targets.
Side effects: Mild burning, rare allergy. Mass Eye and EarPrednisolone acetate 1%
Dose: Typically 4×/day, then slow taper over ~6 months, then low maintenance per inflammation.
Purpose: Control inflammation and lower RPM/melt risk.
Mechanism: Corticosteroid anti-inflammatory.
Side effects: Can raise IOP, delay healing, increase infection risk; requires close follow-up. Mass Eye and EarEyeWikiPeribulbar triamcinolone (20–40 mg)
Timing: As needed for spikes of inflammation or after YAG membrane laser.
Purpose: Longer-acting inflammation control.
Side effects: IOP rise, ptosis, rare infection. Mass Eye and EarGlaucoma drops (aqueous suppressants first)
Typical picks: Timolol 0.5% 1–2×/day; Brimonidine 0.2% 2–3×/day; Dorzolamide 2% 2–3×/day.
Purpose: Lower IOP—key to protect the optic nerve.
Mechanism: Reduce aqueous production or increase outflow.
Side effects: Timolol—fatigue/bronchospasm; Brimonidine—dry mouth/drowsiness; Dorzolamide—stinging. Prostaglandins are usually avoided early after KPro. Mass Eye and EarOral acetazolamide (e.g., 250 mg 2–4×/day as directed)
Purpose: Extra IOP lowering when drops aren’t enough.
Mechanism: Carbonic anhydrase inhibition (less aqueous).
Side effects: Tingling, urination, fatigue, low potassium; avoid in sulfa allergy. Mass Eye and EarCycloplegics (e.g., atropine 1% once–twice daily as directed)
Purpose: Calm painful ciliary spasm, stabilize blood-aqueous barrier in inflammation.
Mechanism: Temporarily paralyzes ciliary muscle and dilates pupil.
Side effects: Light sensitivity, blurred near vision.Antifungal pulses in high-risk climates (e.g., natamycin 5% or amphotericin B 0.15%)
Dose: Twice daily for 1 week every 2–3 months (clinic-directed; only in high-risk settings).
Purpose: Reduce fungal colonization/infection on lens/surface.
Mechanism: Topical antifungal “burst” strategy.
Side effects: Surface irritation; access and cost issues. cdn.amegroups.cnOral doxycycline (e.g., 50–100 mg twice daily short-term)
Purpose: Anti-collagenase support when the surface is at risk of melt.
Mechanism: MMP-9 and cytokine modulation; helps the cornea resist enzymatic breakdown.
Side effects: Sun sensitivity, stomach upset; avoid in pregnancy/children. PMC
Dietary & supportive supplements
Supplements do not replace your prescribed drops. Evidence for some items is mixed; talk to your doctor before starting anything new.
Vitamin C (ascorbic acid)
Dose (typical oral ranges): 500–1000 mg/day (if your doctor approves).
Function: Supports collagen production and corneal wound healing; antioxidant.
Mechanism: Cofactor for collagen cross-linking; reduces oxidative stress. e-acnm.orgOral doxycycline (listed above as a drug, included here for its anti-collagenase “supportive” role)
Function/mechanism: Dampens MMP-9 and inflammatory cytokines to lower melt risk. PMCVitamin A (dietary or medically supervised supplements)
Function: Maintains goblet cells and ocular surface health; prevents xerophthalmia if deficient.
Mechanism: Epithelial health & mucin production. Avoid excess. NCBIOmega-3 fatty acids (fish oil)
Function: May help some people’s dry-eye symptoms; large RCTs show mixed benefit.
Mechanism: Anti-inflammatory lipid mediators. New England Journal of MedicineZinc (with copper if high-dose/long-term)
Function: Cofactor in epithelial repair; supports vitamin A transport.
Mechanism: Enzymatic support in healing. e-acnm.orgVitamin E
Function: Antioxidant; may aid healing synergy with vitamin C.
Mechanism: Limits lipid peroxidation in tissues. e-acnm.orgAdequate protein
Function: Building blocks for repair (collagen, enzymes).
Mechanism: Supplies amino acids for tissue remodeling. e-acnm.orgHydration (water intake)
Function: Supports tear volume and tissue perfusion.
Mechanism: Adequate fluid balance aids healing. e-acnm.orgLutein/zeaxanthin (diet-first; supplements if advised)
Function: Retinal antioxidants; while more retina-focused, a healthy eye benefits overall.
Mechanism: Filters blue light, quenches reactive oxygen species. PMCVitamin D (if deficient)
Function: Immune modulation; general healing support.
Mechanism: Regulates inflammatory pathways.B-complex (especially B6/B12 if deficient)
Function: Nerve health, general metabolism for repair.Magnesium (if low)
Function: Enzyme cofactor; may aid smooth muscle and vascular tone.Selenium (trace, if low)
Function: Antioxidant enzyme cofactor (glutathione peroxidase).Probiotics (adjunctive)
Function: Gut-immune modulation; may indirectly affect inflammation.Whole-food diet pattern (leafy greens, citrus, fish, legumes, nuts)
Function: Delivers the above nutrients from food, which is the preferred source for most people. PMC
Regenerative/biologic” therapies
Autologous serum (AS) eye drops
Dose: Commonly 20% or 50%, several times daily (e.g., 6×/day), course and strength tailored by your specialist.
Function: Delivers growth factors similar to natural tears; helps stubborn surface defects.
Mechanism: EGF, vitamin A, albumin, and other factors nourish epithelium. Evidence supports benefit in severe ocular surface disease. PMC+1Platelet-rich plasma (PRP) eye drops
Dose: Often 6×/day in clinical protocols; duration individualized.
Function: Concentrated platelets release healing factors that stimulate epithelial repair.
Mechanism: PDGF, TGF-β, VEGF, and others from activated platelets. NaturePMCCenegermin (recombinant human nerve growth factor, 20 µg/mL)
Dose: 1 drop 6×/day for 8 weeks.
Function: Treats neurotrophic keratitis (if present), improving corneal healing.
Mechanism: Nerve growth factor promotes corneal nerve and epithelial recovery.
Side effects: Eye pain, redness; cold-chain handling. NCBIOXERVATE® (cenegermin-bkbj)Amniotic membrane (in-office graft) or amniotic extract drops
Dose: Single or repeat grafts; extract drops per protocol.
Function: Anti-inflammatory, pro-healing matrix for persistent defects.
Mechanism: Heavy-chain hyaluronan and growth factors modulate inflammation and promote epithelialization. PMC+1Umbilical-cord serum drops (specialized centers)
Function: Similar to AS/PRP with potentially higher growth-factor content.
Mechanism: Regenerative and immunomodulatory factors. PubMedLimbal stem cell transplantation (for severe LSCD, typically before or as part of the journey toward KPro in selected cases)
Function: Rebuilds the ocular surface and can improve device retention in the right setting.
Mechanism: Restores corneal epithelial stem cells; often requires systemic immunosuppression if allogenic. ScienceDirect
Note: Experimental mesenchymal stem-cell eye drops or grafts are under study; discuss risks, access, and evidence with your specialist.
Surgeries
Boston KPro Type I implantation
Procedure: Open-sky corneal surgery; donor corneal “button” is clamped between the KPro plates and sutured into the eye like a transplant.
Why: Restore a clear optical pathway when standard grafts are unlikely to last. Review of OphthalmologyBoston KPro Type II implantation
Procedure: Similar device with a longer front cylinder brought through a surgically closed eyelid opening (tarsorrhaphy).
Why: For end-stage dry, cicatrized surfaces where a BCL cannot be retained. EyeWikiGlaucoma drainage device (e.g., Ahmed valve), often via pars plana
Procedure: Tube shunt implanted (sometimes combined with vitrectomy) to control pressure.
Why: Glaucoma is common and can silently steal vision after KPro. Mass Eye and EarYAG laser membranotomy (for RPM)
Procedure: In-clinic laser creates an opening in the retroprosthetic membrane; low energies to protect the KPro.
Why: Clears the cloudy film that can blur vision. Mass Eye and EarPars plana vitrectomy (PPV)
Procedure: Microsurgery to treat retinal detachment, vitreous hemorrhage, or to place a posterior tube.
Why: Manages sight-threatening posterior problems and can lower future risks. Review of Ophthalmology
Practical prevention habits
Never skip daily antibiotic prophylaxis—it’s lifelong. Mass Eye and Ear
Keep the BCL on unless your clinic tells you otherwise; have it changed on schedule. Review of Contact Lenses
No water on lenses: no swimming/hot tubs/showering with lenses exposed. CDC
Report any new redness, pain, discharge, or vision drop immediately—don’t “wait it out.”
Avoid topical NSAIDs unless your surgeon specifically recommends them; they’re linked to rare corneal melt in vulnerable corneas. ScienceDirectPubMed
Control eyelid disease (blepharitis/MGD) with hygiene and warm compresses.
Use preservative-free tears liberally if advised; avoid eye rubbing.
Wear protective eyewear outdoors and during dusty or windy activities.
Keep autoimmune disease under control with your medical team. EyeWiki
Stick to your follow-up calendar—problems are easier to fix when caught early. Mass Eye and Ear
When to see a doctor urgently
Sudden vision drop, a new veil, or flashing lights (possible membrane, bleeding, retinal tear/detachment). Review of Ophthalmology
Increasing pain, marked redness, or pus-like discharge (possible infection).
Severe light sensitivity, new floaters, or a shadow in your side vision.
Bandage lens lost and you can’t replace it soon—call for instructions.
Any time your IOP/glaucoma eye feels different (ache/headache/haze). PMC
Diet: “Eat this / avoid that” tips
What to eat more of
Citrus, berries, guava, peppers → vitamin C for collagen and healing. e-acnm.org
Leafy greens (spinach/kale), eggs → lutein/zeaxanthin for overall eye health. PMC
Oily fish (salmon/sardine) → omega-3s; diet sources preferred. New England Journal of Medicine
Legumes, nuts, seeds → zinc, vitamin E, plant proteins. e-acnm.org
Lean proteins (fish, poultry, tofu, dal) → building blocks for repair. e-acnm.org
What to limit/avoid
6) Smoking & secondhand smoke → impairs healing.
7) Excess alcohol → dehydrates and can disturb sleep/tears.
8) Very spicy or hot steam near the face (when lenses are on) → irritation.
9) Ultra-processed high-salt snacks → can worsen dehydration.
10) Self-prescribed high-dose supplements—especially vitamin A if not deficient. Always ask your doctor. NCBI
Common complications
Retroprosthetic membrane (RPM): a hazy tissue behind the optic; often treatable by YAG laser; titanium back plates and inflammation control help reduce it. Mass Eye and EarAmerican Academy of Ophthalmology
Infections (keratitis/endophthalmitis): minimized by lifelong antibiotics and BCL. Report symptoms fast. Mass Eye and Ear
Sterile corneal melt: thinning of donor graft around the optic; early detection by AS-OCT; risk reduced by BCL, inflammation control, and sometimes doxycycline support. SciELOPMC
Glaucoma: very common and vision-threatening; requires aggressive monitoring/treatment, sometimes with early tube shunt. PMC
Retinal detachment/vitreous hemorrhage: uncommon but serious; managed by retinal surgeons, sometimes through the KPro. Review of Ophthalmology
FAQs
Is the KPro a transplant or an implant?
Both—there’s a small donor cornea “carrier,” but the clear center is a permanent implant.How long does a KPro last?
The device is designed to be permanent, but the surrounding tissues need lifelong care with drops, lenses, and check-ups. Mass Eye and EarWill I need drops forever?
Yes. Daily antibiotic prophylaxis and usually a low-dose steroid are lifelong to prevent inflammation and infection. Mass Eye and EarDo I always have to wear a contact lens?
Yes (Type I). The BCL protects the donor cornea and lowers melt/infection risk. Your clinic will handle exchanges. Mass Eye and EarCan I shower or swim with the lens?
Avoid water on lenses. No swimming or hot tubs. Keep shower water away from eyes. CDCCan my eye pressure be measured normally?
No; corneal tonometers don’t work on a plastic window. Doctors use palpation, specialized devices, and optic nerve tests. PMCWhy do doctors worry so much about glaucoma?
Because it’s common after KPro and can silently damage the optic nerve—even when the front window is crystal clear. PMCWhat is an RPM and why might I need a laser?
An RPM is a thin scar-like film behind the KPro; a brief YAG laser can open it to clear the view. Mass Eye and EarAre there antifungal drops too?
Some centers use short pulses in high-risk regions to reduce fungal colonization; not everyone needs them. cdn.amegroups.cnCan I use over-the-counter redness drops or NSAID drops?
Don’t start anything new without asking your surgeon; topical NSAIDs have been linked (rarely) to corneal melt in vulnerable corneas. ScienceDirectDoes titanium mean I can’t have an MRI?
Titanium KPro components are MR-conditional under standard clinical settings; your team will guide imaging safely. Mass Eye and EarWhat if the lens falls out or hurts?
Call your clinic. A lost or damaged BCL should be replaced by the care team; do not reuse old lenses or water-rinse them. CDCWill I need glaucoma surgery?
Many patients do at some point. Decisions are individualized; tube shunts are common. Mass Eye and EarCan the KPro be used if my other eye still sees well?
Historically surgeons were cautious, but patient selection is evolving; your team will weigh risks/benefits carefully. EyeWikiWhat’s the single best thing I can do?
Show up for every visit and use your drops exactly as prescribed. That combo prevents most serious problems. Mass Eye and Ear
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.
The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members
Last Updated: August 12, 2025.
