Oculoplastic considerations in boston keratoprosthesis

Oculoplastic considerations are relatively common in patients with Boston keratoprosthesis as severe corneal and ocular surface disease may also adversely affect the eyelids and adnexal structures. Thus, a significant number of patients require preoperative and postoperative oculoplastic interventions including fornix reconstruction, tarsorrhaphy, and repair of eyelid malpositions and blepharoptosis, which are important to maintain viability of the implanted keratoprosthesis. In addition, oculoplastic procedures are part of the standard operative technique in Boston keratoprosthesis type 2 and play a critical component in the ongoing management of postoperative complications such as skin retraction. Despite the complexity of addressing the periocular issues in these patients, oculoplastic and eyelid procedures are well tolerated and play an important role in maximizing the success of Boston keratoprosthesis implantation.