October 2013

THE BOSTON KERATOPROSTHESIS

CLICK-ON

USERS MANUAL

James Chodosh, Claes H. Dohlman, Larisa Gelfand

 October 2013

BOSTON KERATOPROSTHESIS

CLICK-ON

Table of Contents:

Descriptive Information

1. Description of the Device 3

2 General Indications for Use 4
3. Contraindications 4
4. Indications 4

Operating and Assembly Information

5. Surgical Procedure 6
6. Potential Complications and Adverse Events 10
7. Examples of Boston Keratoprosthesis Postoperative Appearance 12
8. Instructions for Assembly and Implantation 13
9. MRI Compatibility 16
10. To Place a Boston Keratoprosthesis Order 17
11. Sample Operative Note for Boston Keratoprosthesis Type I Click-On 19
Design
12. FDA Permission for marketing 21
13. Boston Keratoprosthesis Bibliography 24

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DESCRIPTIVE INFORMATION

1. DESCRIPTION OF THE DEVICE

The Boston Keratoprosthesis is designed as an “artificial cornea” that can be used in patients
with severe corneal opacity.

The Boston keratoprosthesis is used after standard penetrating keratoplasty has failed or when
such a transplant would be unlikely to succeed. Thus, keratoprosthesis implantation is a
procedure designed to help patients whose corneal diseases are the most difficult to treat.

The Boston keratoprosthesis Click-On design* consists of only two components: a front plate
made of clear polymethyl methacrylate (PMMA) plastic, and a back plate made of titanium that
locks the device in place around a corneal donor graft, The Boston keratoprosthesis when fully
assembled has the shape of a collar-button. The front plate acts as a lens and is provided in
aphakic version compatible with a variety of axial lengths or in pseudophakic version when an
intraocular lens is present and assumed to target emmetropia.

The device comes in two versions, type I (for wet eyes with normal eyelids, preocular tear film,
and blink mechanism) and type II (for severely dry and scarred eyes, and implanted through the
eyelid). The type II is used much less commonly and is reserved for patients with severe
autoimmune diseases, after severe chemical injuries, and in end stage dry eye conditions.

Both device types are assembled within a corneal graft, which is then sutured into the patient’s
cornea as in standard transplantation. If the natural crystalline lens is in place, it is also removed.
After implantation of a type I device, a soft contact lens is applied to the surface, and is worn
continously.

The type II device has an anterior extension to allow it to protrude through surgically closed
eyelids. Because the eyelids are permanently closed, there is no need for a contact lens. Aside
from the surgical aspects of eyelid closure, the devices and the surgery are similar.

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2. INDICATIONS FOR USE

The Boston Keratoprosthesis is indicated to provide a transparent optical pathway through an

opacified cornea in an eye that is not a reasonable candidate for any form of corneal
transplant, including penetrating keratoplasty.

3. CONTRAINDICTIONS

3.1 BOSTON KERATOPROSTHESIS TYPE I

• Patients with autoimmune diseases (e.g, mucous membrane pemphigoid, Stevens-

Johnson syndrome, uveitis, Sjögren’s syndrome) and after severe chemical burns, or
other severe inflammations (these patients if operable, require the type II device)
• Patients with longstanding severe intraocular inflammation and/or phthisis bulbi.
• Patients with retinal detachment or extreme optic nerve cupping
• Patients without intact nasal light projection (to exclude end stage glaucoma)
• Patients with vision better than 20/200 (and whose opposite eye has good vision)

3.2 BOSTON KERATOPROSTHESIS TYPE II

• Patients with longstanding severe intraocular inflammation and/or phthisis bulbi.

• Patients with retinal detachment or extreme optic nerve cupping
• Patients without intact nasal light projection (to exclude end stage glaucoma)
• Patients with vision better than 20/200 (and opposite eye has good vision)

4. INDICATIONS

4.1 BOSTON KERATOPROSTHESIS TYPE I

• Patients with at least one failed corneal transplant, with poor prognosis for further
grafting, or severe corneal opacity and vascularization with poor prognosis for corneal
transplantation
• Patients with vision worse than 20/200 (and opposite eye has reduced vision)

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4.2 BOSTON KERATOPROSTHESIS TYPE II

• Patients with corneal scarring/opacity with poor blink mechanisms, severe dry eye,
and/or severe cicatricial conjunctival scarring sufficient to preclude either successful
corneal transplantation or successful retention of a contact lens after Boston
keratoprosthesis type I implantation
• Patients with vision worse than 20/200 in both eyes

• All other considerations are the same for Boston Kpro type I and II

4.3 SPECIFIC INDICATIONS FOR CLICK-ON DESIGN

The click-on design with titanium back plate is the only choice to be offered for Boston

keratoprosthesis type II implantation, in which the back plate color and appearance is invisible to

the patient, and the advantage of titanium (lower rate of retroprosthetic membrane formation) is

decisive. For patients in whom the Boston keratoprosthesis type I is indicated, the surgeon

should discuss the choice of PMMA (Snap-On design, an older design, which combines a

PMMA front plate, a PMMA back plate, and a titanium locking ring, and requires an extra step

to assemble) or titanium (Click-On design) with the patient, and can show examples of the

postoperative appearance of each design to facilitate the decision. The PMMA back plate affords

a more natural postoperative appearance, while the titanium back plate is associated with a

reduced rate of retroprosthetic membrane formation after surgery, and thus a reduced need for

postoperative YAG laser or surgical membranotomy, with or without replacement of the

keratoprosthesis.

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OPERATING AND ASSEMBLY INFORMATION

5. SURGICAL PROCEDURES
Warnings and Precautions
• Patients under consideration for keratoprosthesis implantation must be free of
external signs of ocular infection or malignancy
• Patients must show understanding of the need for life-long topical medications and
follow-up care
• A complete assessment of the visual potential of the eye to be operated on, including
investigations for existing glaucoma or retinal detachment is essential
Preoperative Evaluation:
• Standard preoperative medical assessment
• General or retrobulbar anesthesia are both acceptable for Boston keratoprosthesis type
I, but general anesthesia should be used for type II
• Single dose of intravenous antibiotic is recommended during surgery (e.g. cefazolin
or levofloxacin, if no allergy)
Surgical Technique
• Assemble corneal graft and Boston keratoprosthesis on a side table. Trephine an 8.5
mm graft from fresh cornea
• Trephine a central 3.0 mm hole in the graft (Acu·Punch®)
• Remove the front plate and back plate from sterile container
• Place the front plate of the keratoprosthesis upside down on a sterile table or on
supplied adhesive
• Slide corneal donor graft down over the front plate stem, and press gently down with
the hollow end of the assembly device
• Apply viscoelastic over the graft endothelium
• Slide the back plate over the stem and push it into place gently with the assembly
device
• Inspect the assembled keratoprosthesis under the operating microscope

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• Place the assembled keratoprosthesis back into the corneal storage solution until
needed
The Patient’s Eye:
• [If keratoprosthesis type II is to be implanted, remove all the ocular surface
epithelium, including all conjunctival epithelium, and the peripheral corneal
epithelium]
• Trephine the host cornea with an 8.0 mm diameter trephine
• If heavy bleeding occurs at the cut corneal edge, cauterize the groove with Jeweler’s
cautery
• Open the corneal wound with surgical blade, and excise the button with corneal
scissors
• Perform peripheral iridectomy if iris is intact
• If the pupil is too small or decentered relative to the keratoprosthesis optic, enlarge it
with sphincterotomies
• If eye is pseudophakic, leave the IOL in place, and use a keratoprosthesis with optical
power chosen for pseudophakia (axial length measurement not necessary)
• If the eye is phakic, perform extracapsular extraction, open-sky, and implant a
keratoprosthesis with optical power chosen for aphakia with the patient’s specific
axial length
• If the eye is already aphakic, implant a keratoprosthesis with optical power chosen for
aphakia with the patient’s specific axial length
• Suture the corneal graft with assembled keratoprosthesis with twelve 9-0 nylon
sutures in interrupted fashion. Bury the knots. Do not suture through the back plate
holes or otherwise incorporate the back plate in the suture tracts.
• Cover the keratoprosthesis optic during surgery with a moistened surgical sponge to
protect the macula against light damage from the operating microscope
• Administer peribulbar antibiotic injections
• For keratoprosthesis type I, apply soft contact lens of at least 16 mm diameter, with
flat base curve
• Apply semipressure eyelid patch and eye shield

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• Additional procedures for the keratoprosthesis type II

o Inject the eyelid margins with lidocaine with epinephrine and excise the margin,
with care to include the eyelash follicles in the excised tissue
o Suture the upper and lower tarsal plates together around the anterior
keratoprosthesis stem, with 6-0 vicryl suture in interrupted fashion
o Suture the upper and lower eyelid skin together with bolsters and 8-0 nylon
sutures in mattress fashion
o With vannas scissors, cut a round notch in the upper eyelid to allow the
keratoprosthesis stem to protrude between the eyelids
o Place antibiotic ointment to the eyelid margins and upper eyelid notch
o Apply semi-pressure eye patch and eye shield

Postoperative Care:
After uncomplicated keratoprosthesis type I, the patient should be seen the following day,
and then at minimum, again after one week, one month, every two months for the first
year, and then every three to six months. After keratoprosthesis type II implantation,
patients need more frequent follow-up for the first two weeks after surgery, 2-3 times per
week, to keep secretions from covering the anterior surface of the keratoprosthesis. At
two weeks after surgery, the eyelid sutures and bolsters can be removed.

NOTE: Keratoprosthesis requires a more detailed postoperative follow up regimen than

standard keratoplasty.

Postoperative Medications
Postoperative topical corticosteroids and antibiotics must be administered beginning on the
first postoperative day, and antibiotics continued for the life of the patient.
To achieve the broadest antimicrobial spectrum with the least risk of developing bacterial
resistance, two antibiotics with different mechanisms of action are recommended, for
example a fluoroquinolone and vancomycin, or trimethoprim and polymixin B in
combination.

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Soft Contact Lenses:

• Patients with a keratoprosthesis type I should wear an appropriate extended wear soft
contact lens, which should be cleaned or replaced per the contact lens manufacturer’s
instructions
• If lens deposits occur (in poorly blinking eyes), a hybrid contact lens (soft periphery,
rigid center) can provide a clear visual axis
• Close collaboration with your Contact Lens Service is advised.

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6. POTENTIAL COMPLICATIONS AND ADVERSE EVENTS

• In general, postoperative inflammation is not unusual in eyes that have undergone many
surgical procedures. In addition to topical steroids, peribulbar injection of 40 mg of
triamcinolone may be indicated for intraocular inflammation following keratoprosthesis
implantation
• A retroprosthetic membrane can be opened with YAG laser (power less than 2.0 mJ) as
long as the membrane is avascular
• Vascularized membranes require repeat keratoprosthesis surgery with intraoperative
excision.
• Necrosis and melt of corneal tissue around the keratoprosthesis are rare, but if perforation
is present or threatened, immediate replacement of the keratoprosthesis is recommended
• Sterile vitritis after keratoprosthesis implantation is characterized by a sudden drop in
vision, the presence of vitreous inflammation in the absence of redness or pain, and no
other abnormalities to explain the drop in vision. Sterile vitritis is treated with peribulbar
triamcinolone (20-40 mg). The surgeon should have a low threshold for referring the
patient for therapy of endophthalmitis if there is any concern based on the clinical signs.
• Infectious keratitis following keratoprosthesis implantation is uncommon if the patients
are using prophylactic topical antibiotics. Diagnostic culture and gram stain followed by
appropriate antimicrobial therapy for microbial keratitis is indicated
• Microbial endophthalmitis is rare in non-autoimmune patients as long as prophylactic
antibiotics are used. If present, microbial endophthalmititis occurs consecutive to a
microbial keratitis around the keratoprosthesis stem. If microbial endophthalmitis is
evident or suspected by clinical signs and symptoms, immediate referral to a vitreoretinal
surgeon for vitreous biopsy and intravitreal antimicrobial injections is indicated
• Glaucoma is a common comorbidity in patients needing keratoprosthesis implantation,
and new onset or worsening of preexisting glaucoma must be monitored for after
keratoprosthesis implantation.
• Finger palpation is currently the only means of determining intraocular pressure after
keratoprosthesis implantation. Optic nerve photographs and visual field testing are
indicated on a regular basis following keratoprosthesis surgery

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• For patients with preexisting glaucoma, a glaucoma drainage device should be placed
prior to or concurrent with implantation of the keratoprosthesis. For those that
develop glaucoma anytime following keratoprosthesis surgery, strong consideration
should be given to implantation of a glaucoma drainage device.
• Topical glaucoma medications can be used after implantation of a keratoprosthesis
type I, but do not penetrate the closed eyelids after keratoprosthesis type II, in which
case, oral carbonic anhydrase inhibitors are the only medical solution

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7. EXAMPLES OF BOSTON KERATOPROSTHESIS POSTOPERATIVE

APPEARANCE

Implanted
Boston
Keratoprosthesis
Type I

Implanted Boston
Keratoprosthesis
Type II

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8. INSTRUCTIONS FOR ASSEMBLY AND IMPLANTATION

• Photographs of the component parts of the

Boston keratoprosthesis:
• Type I (top)
• Type II (bottom)

Schematic illustration of the components:

• The front plate consists of a front plate and the
stem
• The back plate (8.5 mm diameter)

• White assembly tool with a hollow bore will

assist in the assembly.

• After an 8.5 mm corneal graft is punched out

from a donor cornea, a 3.0 mm hole is punched.
Central position of the hole is important.

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• An adhesive patch is used to stabilize the

Boston Keratoprosthesis assembly. Scotch
tape is peeled off.

• The bared adhesive is pressed down onto a

stable surface. The cover of one of the top
windows is peeled off, baring the adhesive.

• The KPro front plate is pressed down onto the

adhesive (plate down, stem up) where it sticks.

• Viscoelastics applied around the stem. The

corneal graft slides down over the stem.

• The hollow bore end of the white pin is used to

gently push the graft down over the stem.

• More viscoelastics applied on the endothelial

surface. Important!

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• The back plate is placed on the stem.

• The back plate is gently pushed down with a

finger onto the stem. Finally, with the white
assembly pin, give final push to have back plate
click into the grove on the stem.

• The position of the back plate should be

inspected prior to implantation.

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9. MRI INFORMATION

MR Conditional

The Boston Keratoprosthesis, back plate and locking ring made from titanium is
MR-conditional.

Non-clinical testing demonstrated that the Boston Keratoprosthesis, back plate and
locking ring made from titanium is MR Conditional. A patient with this device can be
scanned safely immediately after placement under the following conditions:

Static Magnetic Field

• Static magnetic field of 3-Tesla or less
• Maximum spatial gradient magnetic field of 720-Gauss/cm or less

MRI-Related Heating
In non-clinical testing the Boston Keratoprosthesis (back plate and locking ring made
from titanium) produced a maximum temperature rise < 1.5°C during 15 minutes of
continuous MR scanning in the First Level Controlled Mode at a maximum whole-body
averaged SAR of 4 W/kg and a maximum head averaged SAR of 3.2 W/ kg.
This was assessed by calorimetry in a 3-Tesla/128 MHz field using a General Electric
Excite HDx MR Scanning System (3-Tesla/128-MHz, Excite, HDx, Software 14X.M5,
General Electric Healthcare, Milwaukee, WI).

Artifact Information
MR image quality may be compromised if the area of interest is in the exact same area
or relatively close to the position of the Boston Keratoprosthesis, back plate and locking
ring made from titanium. Therefore, optimization of MR imaging parameters to
compensate for the presence of this device may be necessary. The maximum artifact
size (i.e., as seen on the gradient echo pulse sequence) extends approximately 10-mm
relative to the size and shape of the Boston Keratoprosthesis, back plate and locking
ring made from titanium.

Pulse Sequence T1-SE T1-SE GRE GRE

Signal Void Size 97-mm2 35-mm2 290-mm2 296-mm2
Plane Orientation Parallel Perpendicular Parallel Perpendicular

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10. TO PLACE A BOSTON KERATOPROSTHESIS ORDER

The Boston Keratoprosthesis can be purchased from “Boston Keratoprosthesis”, Massachusetts

Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114
Phone: (617) 573-4463
Fax: (617) 573 4369
Email: kpro_service@meei.harvard.edu
See order form on the next page.
Please include Purchase Order Form from your Purchasing Department.

Package includes 3.0 mm trephine, contact lens, and assembly tool.

A corneal graft is needed to assemble and implant the keratoprosthesis. Usually a fresh human
donor graft is utilized. However, the patient’s excised corneal button can also be used as carrier
graft if a fresh corneal graft is not available, and the patient’s cornea is of normal thickness.

When ordering, please state whether for a pseudophakic or aphakic eye. If for aphakia, provide
us the axial length of the patient’s eye.

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11. SAMPLE OPERATIVE NOTE FOR BOSTON KERATOPROSTHESIS

TYPE I CLICK-ON DESIGN
Patient: Date: Unit #:

Surgeon: Assistant:

Preoperative Diagnosis: Repeated corneal graft failures OD/OS

Postoperative Diagnosis: Same

Name of Operation: Keratoprosthesis Type I Click-on design, intended for

(pseudophakia/aphakia) in fresh corneal graft, (ECCE/Vitrectomy), plus soft contact lens
placement OD/OS

Anesthesia: General/local

Indication for Surgery: Visual

Procedure: The corneal graft was prepared on a side table. The donor cornea was placed in a
Teflon well and with an 8.5 mm trephine a corresponding full thickness donor corneal graft was
trephined. Then, a 3.0 mm trephine opening was made centrally. The keratoprosthesis container
was opened and the parts were removed and examined. The keratoprosthesis with serial #
_________, was recommended for pseudophakia (or aphakia with an axial length of _____ mm).
The back plate, had a diameter of 8.5 mm.

The keratoprosthesis front plate was placed upside down on the supplied adhesive. The corneal
graft was slid over the stem and was gently pushed down with the hollow end of the assembly
tool. Viscoelastic was applied to the endothelial surface of the graft. The back plate was then
placed over the stem and firmly locked into its groove with vertical pressure from the assembly
tool. The keratoprosthesis was then inspected under the operating microscope for proper
assembly. Finally, the assembled keratoprosthesis and attached corneal graft were placed back
into the corneal storage solution provided with the cornea.

Attention was then focused on the patient’s cornea. With an 8.0 mm diameter corneal trephine,
the cornea was trephined to partial thickness. (There was some bleeding and cautery was
performed). The corneal wound was opened with sharp blade and the excision of the corneal
button completed with corneal scissors.

(A peripheral iridectomy was done. Sphincterotomies were cut to enlarge the pupil.
Extracapsular cataract extraction was performed. The anterior capsule was opened with Vannas
scissors, and the lens nucleus was hydrodissected. The nucleus delivered by light pressure.
Cortical remnants were removed with the standard irrigation/aspiration. The posterior capsule
remained intact. No intraocular lens was placed.)

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Finally the assembled keratoprosthesis and corneal graft were removed from the corneal storage
media and placed back plate down in the corneal wound. Twelve 9-0 nylon sutures were placed
in interrupted fashion and the knots buried. During the suturing the macula was protected from
light damage by a cellulose sponge over the center of the keratoprosthesis. The wound was
checked carefully and was water tight. A soft contact lens was placed over the eye. Periocular
antibiotics were administered. A patch and shield were applied. The patient was taken to the
recovery room in stable condition.

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13. BOSTON KERATOPROSTHESIS BIBLIOGRAPHY

Revised – May 2, 2013

1. Dohlman CH, Webster RG, Biswas SK, Doane MG, Holmberg A. Collar-button prosthesis
glued to a corneal graft. In: Polack, FM, ed. Cornea and External Diseases of the Eye. First
Inter-American Symposium. Springfield, IL: Charles C. Thomas, 1970:189-192.

2. Dohlman CH, Schneider H, Doane MG. Prosthokeratoplasty. Am J Ophthalmol. 1974;

77(#5):694-700.

3. Dohlman CH. Biology of complications following keratoprosthesis. Cornea. 1983;

2(3):175-176.

4. Dohlman CH. Postoperative regimen and repair of complications after keratoprosthesis

surgery. Refract and Corneal Surg. 1993; 9:198.

5. Dohlman CH, Doane MG. Some factors influencing outcome after keratoprosthesis
surgery. Cornea 1994; 13:214.

6. Dohlman CH: Keratoprostheses. In: Albert D, Jakobiec FJ, editors. Principles and Practice
of Ophthalmology. Philadelphia: WB Saunders; 1994: 338-342.

7. Dohlman CH, Doane MG. Keratoprosthesis in end-stage dry eye. In: Sullivan DA ed.
Lacrimal gland, tear film and dry eye syndromes. New York: Plenum Press; 1994, p. 561-
564.

8. Dohlman CH, Terada H. Keratoprosthesis in pemphigoid and Stevens-Johnson syndrome.

In: Sullivan DA, ed. Lacrimal gland, tear film and dry eye syndromes. New York: Plenum
Press; 1994. p. 1021-1025.

9. Doane MG, Dohlman CH, Bearse G. Fabrication of a keratoprosthesis. Cornea 1996;

15:179-184.

10. Dohlman CH, Terada H. The management of severe ocular surface disease. In: The first
international symposium of ophthalmology. Japanese Ophthalmological Society, 1996, p
311-314.

11. Dohlman CH, Waller SG, Netland PA. Keratoprosthesis surgery. In: Lindquist T and
Lindstrom R, eds.Ophthalmic surgery Update #4. Chicago: Mosby; 1996. V-L-0-V-L-24.

12. Dohlman CH. Keratoprosthesis. In: Krachmer JH, Mannis MJ, Holland EJ, eds. Cornea.
St. Louis: Mosby; 1997, p 1855-1863.

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13. Teichmann K, Wagoner MD, Al-Raji A, Badr I, Netland PA, Dohlman CH. Surgical
rehabilitation of end-stage ocular cicatricial pemphigoid with the Dohlman-Doane
keratoprosthesis. In: XIth Congress of the European Society of Ophthalmology. Budapest:
1997. p. 259-262.

14. Netland PA, Terada H, Dohlman CH. Glaucoma associated with keratoprosthesis.
Ophthalmology 1998; 105:751-757.

15. Dohlman CH, Terada H. Keratoprosthesis in pemphigoid and Stevens-Johnson syndrome.

Adv Exp Med Biol 1998; 438:1021-1025.

16. Dohlman CH, Netland PA, Fung WC. Experience with a keratoprosthesis. Ann Inst
Barraquer 1999; 28 (Suppl)105-108.

17. Dohlman CH, Waller SG. The Dohlman Keratoprosthesis. In: Brightbill FS, ed. Corneal
surgery: theory, technique and tissue. St. Louis: Mosby; 1999. p. 541-549.

18. Alfonso EC. Clinical experience with the Dohlman-Doane keratoprosthesis. An Inst
Barraquer (Barc) 1999; 28:49-50.

19. Dohlman CH, Power WJ. Keratoprosthesis. In: Albert D, Jakobiec FJ, eds. Principles and
practice of ophthalmology. Philadelphia: WB Saunders, 1999, p.1069-1079.

20. Yaghouti F, Dohlman CH. Innovations in keratoprosthesis: proved and unproved. Int
Ophthalmol Clin 1999; 39:27-36.

21. Dohlman CH. Guillaume Pellier. In: Mannis MJ, Mannis AA eds. Corneal transplantation:
a history of profiles (Hirschberg History of Ophthalmology). Oostende, Belgium: JP
Wayenborgh, 1999. p. 53-64.

22. Dohlman CH, D’Amico DJ. Can an eye in phthisis be rehabilitated? A case of improved
vision with 1 year follow-up. Arch Ophthalmol 1999; 117:123-124.

23. Mannis MJ, Dohlman CH. The artificial cornea: A brief history. In: Mannis MJ, Mannis,
AA eds. Corneal transplantation: a history of profiles (Hirschberg History of
Ophthalmology). Oostende, Belgium: JP Wayenborgh, 1999. p. 321-335.

24. Al-Merjan J, Sadeq N, Dohlman CH. Temporary tissue coverage of keratoprosthesis.

Mid-East J Ophthalmol 2000; 8:12-18.

25. Al-Merjan J, Sadeq N, Dohlman CH. Temporary tissue coverage of keratoprosthesis. Mid
East J of Ophthalmol 2000;8(1):12-18.

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26. Dohlman CH. Outcome after keratoprosthesis surgery: toward common definitions. Ann
Inst Barraquer 2001; 30:233-235.

27. Dohlman CH. Keratoprosthesis in non-cicatrizing conditions. An Inst Barraquer (Barc)

2001; 30:41.

28. Dohlman CH. Glaucoma following keratoprosthesis. An Inst Barraquer 2001; 30:133.

29. Yaghouti F, Nouri M, Abad JC, Power WJ, Doane MG, Dohlman CH. Keratoprosthesis:
preoperative prognostic categories. Cornea 2001; 20:19-23.

30. Nouri M, Terada H, Alfonso EC, Foster CS, Durand ML, Dohlman CH. Endophthalmitis
after keratoprosthesis: incidence, bacterial causes, and risk factors. Arch Ophthalmol 2001;
119:484-489.

31. Khan B, Dudenhoefer EJ, Dohlman CH. Keratoprosthesis: an update. Curr Opin
Ophthalmol 2001; 12:282-287.

32. Dohlman CH, Grosskreutz C., Dudenhoefer EJ, Rubin PAD. Can a glaucoma shunt be
safely extended to the lacrimal sac or the ethmoid sinuses in keratoprosthesis patients?
DJO 2001; 7:241.

33. Nouri M, Terada H, Durand ML, Alfonso EC, Dohlman CH. Risk factors for
endophthalmitis in keratoprosthesis patients. An Inst Barraquer (Barc) 2001; 30:123-124.

34. Dohlman CH, Dudenhoefer EJ, Khan BF, Dohlman JG. Corneal blindness from end-stage
Sjögren’s Syndrome and graft-versus-host disease. In: Sullivan D, ed. Lacrimal gland, tear
film and dry eye syndromes. New York: Kluwer Academic/Plenum Publishers; 2002.
p.1335-1338.

35. Ray S, Khan BF, Dohlman CH, D’Amico DJ. Management of vitreoretinal complications
in eyes with permanent keratoprosthesis. Arch Ophthalmol 2002; 120:559-566.

36. Dohlman CH, Dudenhoefer E, Khan BF, Morneault S. Protection of the ocular surface
after keratoprosthesis surgery: the role of soft contact lenses. CLAO J 2002; 28:72-74.

37. Dohlman CH. Do a corneal transplant? Do a keratoprosthesis? Do nothing?: the uncertain

borders between indications. Ann Inst Barraquer 2003; 32:3-4.

38. Dohlman CH, Abad JC, Dudenhoefer EJ, Graney JM. Keratoprosthesis: beyond corneal
graft failure. In: Spaeth G, ed. Ophthalmic surgery. Principles and practice. Philadelphia:
WB Saunders; 2003. p.199-207.

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39. Dudenhoefer EG, Nouri M, Gipson IK, Baratz KH, Tisdale AS, Dryja TP, Abad JC,
Dohlman CH. Histopathology of explanted collar button keratoprosthesis: a
clinicopathologic correlation. Cornea 2003; 22:424-428.

40. Dohlman CH. When corneal grafts have failed: The option of keratoprosthesis. Rev
Refract Surg 2003; 4:31-32.

41. Dohlman CH. Keratoprosthesis in endstage corneal disease. Acta Ophthalmologica

Scandinavica 2004; 1;336-337.

42. Rubin PAD, Chang E, Bernardino CR, Hatton MP, Dohlman CH. Oculoplastic technique
of connecting a glaucoma valve shunt to extraorbital locations in cases of severe glaucoma.
Ophthal Plast Reconstr Surg 2004; 203:62-367.

43. Dohlman CH, Barnes S, Ma J. Keratoprosthesis. Cornea 2nd edition. Krachmer JH,
Mannis MJ, Holland EJ, eds. St. Louis: Mosby-Year Book: 2004. p. 1719-1728.

44. Dohlman CH, Nouri M. Keratoprosthesis surgery. In: Foster CS, Azar D, Dohlman CH
eds., Smolin and Thoft’s The Cornea 4th ed., Philadelphia: Lippincott, Williams and
Wilkins; 2005. p.1085-1095.

45. Abad JC, Dohlman CH. Queratoprotesis. In: Benitez del Castillo JM, Duran JA,
Rodriguez MT, eds. Superficio Ocular. LXXX Ponencia Oficial de la Sociedad Espanola
de Oftalmologia. Industria Grafica Mae, SL. Espana 2005. p. 463-470.

46. Nouri M, Durand ML, Dohlman CH. Sudden reversible vitritis after keratoprosthesis: an
immune phenomenon? Cornea 2005; 24: 915-919.

47. Ma J, Graney JM, Dohlman CH. Repeat penetrating keratoplasty versus the Boston
Keratoprosthesis in graft failure. Int Ophthalmol Clin N Am 2005; 45:49-59.

48. Aquavella JV, Qian Y, McCormick GJ, Palakuru JR. Keratoprosthesis: The Dohlman-
Doane device. Am J Ophthalmol 2005; 140:1032-1038.

49. Ilhan-Saroc O, Akpek EK. Current concepts and techniques in keratoprosthesis. Current
Opin Ophthalmol 2005; 16:246-250.

50. Dohlman CH, Dohlman JG. Aqueous shunt to the ocular surface for severe dry eyes. DJO
2005; 11:2.

51. Harissi-Dagher M, Dohlman CH. The Boston Keratoprosthesis. Contemp Ophthalmol

2006; 5:1-7.

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52. Dohlman CH, Harissi-Dagher M, Khan BF, Sippel KC, Aquavella J, Graney JM.
Introduction to the use of the Boston Keratoprosthesis. Expert Rev Ophtalmol 2006; 1:41-
48.

53. Bothelo P, Congdon NG, Flanda JE, Akpek EK. Keratoprosthesis in high-risk pediatric
corneal transplantation: First two cases. Arch Ophthalmol 2006; 124:1356-1357.

54. Zerbe BL, Belin MW, Ciolino JB. Results from the Multicenter Boston Type I
Keratoprosthesis Study. Ophthalmology 2006; 113:1779-1784.

55. Aquavella JV, Qian Y, McCormack GJ, Palakuru JR. Keratoprosthesis: Current
techniques. Cornea 2006; 25:656-662.

56. Javadi MA, Nasiri N, Salour H, Bagheri A, Karimian F, Jafarinasab MR, Faramarzi A.
Outcomes of keratoprosthesis at Labbafinejad Medical Center. Bina J Ophthalmol 2006;
11:362-368.

57. Botelho PJ, Congdon NG, Handa JT, Akpek EK. Keratoprosthesis in High-Risk Pediatric
Corneal Transplantation: First 2 Cases. Arch Ophthalmol 2006; 124:1356-1357.

58. Khan BF, Harissi –Dagher M, Dohlman CH. Keratoprosthesis. Albert DM, Miller JW,
editors, Azar DT, Blodi BA, associate editors. In: Albert and Jakobiec’s Principles and
practice in ophthalmology, 3rd Edition. London: Elsevier. December 2007.

59. Barnes SD, Dohlman CH, Durand ML. Fungal colonization in the Boston
Keratoprosthesis. Cornea 2007; 26:9-15.

60. Khan BF, Harissi-Dagher M, Khan DM, Dohlman CH. Advances in Boston
Keratoprosthesis: enhancing retention and prevention of infection and inflammation. Int
Ophthalmol Clin. 2007, 47:61-71.

61. Khan BF, Harissi-Dagher M, Langston DP, Aquavella J. Dohlman CH. The Boston
Keratoprosthesis in Herpes Simplex Keratitis. Arch Ophthalmol. 2007;125:745-749.

62. Kocaturk T, Dohlman CH. Keratoprotez Cerrahisi. Turkiye Klinikleri J Ophthalmol.

2007;16: 47-55.

63. Akpek E, Harissi-Dagher M, Petrarca R, Butrus S, Pineda R, Aquavella J, Dohlman CH.

Outcomes of Boston Keratoprosthesis in aniridia. A retrospective multicenter study. Am J
Ophthalmol 2007; 144: 227-231.

64. Harissi-Dagher M, Khan BF, Schaumberg DA, Dohlman CH. Importance of Nutrition to
Corneal Grafts When Used As a Carrier of the Boston Keratoprosthesis. Cornea. 2007;
26:564-568.

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 October 2013

65. Dohlman CH, Harissi-Dagher M, Graney J. The Boston Keratoprosthesis: A New

Threadless Design. DJO. 2007;13:3.

66. Aquavella JV, Gearinger MD, Akpek EK, McCormick GJ. Pediatric keratoprosthesis.
Ophthalmology 2007; 114:989-994.

67. Coassin M, Zhang C, Green WR, Aquavella JA, Akpek EK. Histopathological and
immunohistochemical aspects of artificial corneal failure. Am J Ophthalmol 2007;
144:699-704.

68. Sayegh RR, Ang LPK, Foster CS, Dohlman CH. The Boston Keratoprosthesis in Stevens-
Johnson Syndrome: An Update. Am J Ophthalmol. 2008;145:438-444.

69. Harissi-Dagher M, Beyer J, Dohlman CH. The role of soft contact lenses as an adjunct to
the Boston Keratoprosthesis. Int Ophthalmol Clin. 2008;48:43.

70. McLellan CL, Ngo V, Pasedia S, Dohlman CH. Long-term stability of vancomycin
ophthalmic solution. Int J Pharm Comp. 2008;12:456-458.

71. Harissi-Dagher M, Colby KA. Cataract extraction after implantation of a Type I Boston
Keratoprosthesis. Cornea. 2008; 27:220-222.

72. Garcia JPS, delaCruz, J, Rosen RB, Buxton G. Imaging implanted keratoprosthesis with
anterior-segment optical coherence tomography and ultrasound biomicroscopy. Cornea.
2008; 2:180-188.

73. Pavan-Langston D, Dohlman CH. Boston Keratoprosthesis:treatment of herpes zoster

neurotrophic keratopathy. Ophthalmology. 2008;115:321-323.

74. Aquavella JV. Keratoprosthesis revisited – Current status of keratoprosthesis surgery.

Contemporary Ophthalmology. 2008;7:1-8.

75. Aquavella JV. Keratoprosthesis in the treatment of congenital cornea opacity.

Contemporary Ophthalmology 2008;7:1-6.

76. Harissi-Dagher M, Dohlman CH. The Boston Keratoprosthesis in severe ocular trauma.
Can J Ophthalmol 2008, 4: 165-169.

77. Dohlman CH, Colby K, Harissi-Dagher M. The Boston Keratoprosthesis: Users manual 3rd
ed. Massachusetts Eye and Ear Infirmary, Boston, MA, USA 2008.

78. John T. Artificial cornea: surgical use of Boston Keratoprosthesis. Ann Ophthalmol 2008;
40:2-7.

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79. Stolz AP, Kwitko S, Dal Pizzol MM, Marinho D, Rymer S. Experience with the Doane-
Dohlman keratoprosthesis: case reports. Arq Bras Oftalmol 2008; 71:257-261.

80. Ament JD, Pineda R II, Lawson B, Behlau I, Dohlman CH. The Boston Keratoprosthesis:
International protocol, version 2.0 June 2009.
http://www.masseyeandear.org/gedownload!/KPro%20International%20Protocol2.pdf?ite
m_id=5816015&version_id=5816016. Accessed August 15, 2009.

81. Waller S., Dohlman CH. The Boston keratoprosthesis. In: Brightbill, F. ed. Corneal
surgery: theory, technique and tissue. 4th ed. St. Louis; Mosby: 2009. p.691-696.

82. Sa-ngiampornpanit T, Thiagalingam S, Dohlman CH. Boston Keratoprosthesis in

epithelial downgrowth. DJO 2009; 15:1.

83. Ciolino JB, Dohlman CH. Biological keratoprosthesis materials. Int Ophthalmol Clin
2009; 49:1-9.

84. Dohlman J, Foster CS, Dohlman CH. Boston Keratoprosthesis in Stevens-Johnson

Syndrome: A case of using infliximab to prevent tissue necrosis. DJO 2009; 15:1-5.

85. Todani A, Gupta P, Colby K. Type I Boston keratoprosthesis with cataract extraction and
intraocular lens placement for visual rehabilitation of herpes zoster ophthalmicus: the
“KPro Triple”. Br J Ophthalmol 2009; 93:119.

86. Aldave AJ, Kamal KM, Vo RC, Yu F. The Boston Type I Keratoprosthesis: improving
outcomes and expanding indications. Ophthalmology 2009; 116:640-651.

87. Bradley JC, Hernandez EG, Schwab IR, Mannis MJ. Boston Type I Keratoprosthesis: The
University of California Davis Experience. Cornea 2009; 28:321-327.

88. Ciolino JB, Hoare TR, Iwata NG, Behlau I, Dohlman CH, Langer R, Kohane DS. A drug-
eluting contact lens. Invest Ophthalmol Vis Sci 2009; 50:3346-3352.

89. Durand ML, Dohlman CH. Successful prevention of bacterial endophthalmitis in eyes with
the Boston Keratoprosthesis. Cornea 2009; 28:896-901.

90. Rivier D, Paula JS, Kim E, Dohlman CH, Grosskreutz CL. Glaucoma and keratoprosthesis
surgery: role of adjunctive cyclophotocoagulation. J Glaucoma. 2009;18:321-324.

91. Ament JD, Spurr-Michaud S, Dohlman CH, Gipson IK. The Boston Keratoprosthesis:
Comparing corneal cell compatibility with titanium and PMMA backplates. Cornea 2009;
28:808-811

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92. Colino JB, Dohlman CH, Kohane DS. Contact lens drug delivery. Semin Ophthalmol
2009; 24:156-160

93. Fintelmann RE, Maguire JI, Ho AC, Chew HF, Ayres BD. Characteristics of
endophthalmitis in patients with the Boston Keratoprosthesis. Cornea 2009; 28:877-878

94. Klufas MA, Starr CE. The Boston Keratoprosthesis. An update on recent advances.
Cataract & Refractive Surgery Today. 2009; 1-3

95. Chew HF, Ayres BD, Hammersmith KM, Rapuano CJ, Laibson PR, Myers JS, Jin,YP,
Cohen EJ. Boston Keratoprosthesis Outcomes and Complications. Cornea.2009; 28:989-
996

96. de la Cruz J, McMahon T. Surveillance cultures of contact lenses of patients with Boston
KPro type keratoprosthesis. EVER Abstract 330. Oct 2, 2009.

97. Truax KA, Osgood BJ, de la Cruz J, McMahon TT. Surveillance cultures of bandage
contact lenses of patients with Boston Type I keratoprosthesis. ARVO 2009:1494.

98. Lekhanont K, Panday V, Akpek EK. Permanent Keratoprosthesis. Part V, Special

Situations in Corneal Surgery, Theory, Technique and Tissue, 4th edition. Eds: F Brightbill,
PJ McDonnell, CNJ McGhee. Assoc. Ed: AA Farjo. Elsevier. China 2009. Chapter 78,
pp 683-690.

99. Sayegh RR, Avena Diaz L, Vargas-Martin F, Webb RH, Dohlman CH, Peli E. Optical
functional properties of the Boston Keratoprosthesis. Invest Ophthalmol Vis Sci 2010;
51:857-863

100. Dohlman CH, Grosskreutz CL, Chen TC, Pasquale LR, Rubin PAD, Kim EC, Durand M.
Shunt to divert aqueous humor to distant epithelialized cavities after Keratoprosthesis
surgery. Risk of infection. Glaucoma 2010; 19:111-115.

101. Dunlap K, Chak G, Aquavella JV, Myrowitz E. Utine CA, Akpek E. Short-term visual
outcomes of Boston Type I Keratoprosthesis implantation. Ophthalmology 2010; 117:687-
692.

102. Garcia JP Jr., Ritterband DC, Buxton DF, de la Cruz J. Evaluation of the stability of
Boston Type I Keratoprosthesis-Donor cornea interface using anterior segment optical
coherence tomography. Cornea. 2010; 29:1031-1035

103. Tay E, Utine CA, Akpek EK. Crescenteric amniotic membrane grafting in
Keratoprosthesis-associated cornea melt. Arch Ophthalmol. 2010; 128:779-782

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104. Yildiz E, Saad C, Eagle R, Ayers B, Cohen E. The Boston Keratoprosthesis in 2 patients
with autoimmune polyendocrinopathy. Cornea. 2010; 29:354-356

105. Kanoff J, Colby K. Pigmented deposits on a Boston Keratoprosthesis from topical

ibopamine. Cornea. 2010; 29:1069-1071

106. Harissi-Dagher M, Khan BF, DohlmanCH. The Boston Keratoprosthesis. In: Corneal
Transplantation. Rasik B Vajpayee, ed, Namrata Sharma, Geoffrey C Tabin and Hugh R
Taylor, co-eds. Vajaypee Brothers Medical Publishers. New Delhi, 2010.

107. Ament JD, Stryjewski TP, Ciolino, JB, Todani A, Chodosh J, Dohlman CH. Cost-
effectiveness of the Boston Keratoprosthesis. Am J Ophthalmol 2010; 149: 221-228

108. Ament JD, Todani A, Pineda II R, Shen TT, Aldave AJ, Dohlman CH, Chodosh J. Global
corneal blindness and the Boston Keratoprosthesis Type I (Editorial). Am J Ophthalmol
2010; 149: 537-539.

109. Ament JD, Tilahun Y, Mudawi E, Pineda R. Role for ipsilateral autologous corneas as a
carrier for the Boston Keratoprosthesis: The African Experience. Arch Ophthalmol 2010:
128:795-797

110. Tsui I, Uslan DZ, Hubschman JP, Deng SX. Nocardia farcinica Infection of a Baerveldt
implant and endophthalmitis in a patient with a Boston Type I Keratoprosthesis. J
Glaucoma 2010; 19:339-340.

111. Vajaranant TS, Blair MP, McMahon T, Wilensky JT, de la Cruz J. Special considerations
for pars plana tube-shunt placement in Boston Type I Keratoprosthesis. Arch Ophthalmol
2010; 128:1480-1482

112. Garrick C, Aquavella JV. A safe Nd:YAG retroprosthetic membrane removal technique
for keratoprosthesis. Cornea 2010; 29:1169-1172

113. Utine CA, Gehlbach PL, Zimer-Galler I, Akpek EK. Permanent keratoprosthesis combined
with pars plana vitrectomy and silicone oil injection for visual rehabilitation of chronic
hypotony and corneal opacity. Cornea 2010; 29:1401-1405

114. Ciralski J, Papaliodis GN, Dohlman CH, Chodosh J. Keratoprosthesis in autoimmune

disease. Ocular Immunology and Inflammation 2010; 18:275-280.

115. Pineles SL, Ela-Dalman N, Rosenbaum AL, Aldave AJ, Velez FG. Binocular visual
function in patients with Boston Type I Keratoprosthesis. Cornea. 2010; 29:1397-1400

116. Klufas MA, Colby KA. The Boston keratoprosthesis. Int Ophthalmol Clin. 2010.50:161-
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117. Georgalas I, Kanellopoulos AJ, Petrou P, Ladas I, Gotzaridis E. Presumed endophthalmitis

following Boston Keratoprosthesis treated with 25 gauge vitrectomy: a report of three
cases. Graefes Arch Clin Exp Ophthalmol 2010; 248:447-450.

118. Jun JJ, Siracuse-Lee DE, Daly MK, Dohlman CH. Keratoprosthesis. In: Cornea and
External Eye Diseases, 2nd ed. Krigelstein GK, Weinreb RN, eds. Springer Verlag, Berlin.
2010; 3:p.137-144.

119. Traish AS, Chodosh J. Expanding application of the Boston type I keratoprosthesis due to
advances in design and improved post-operative therapeutic strategies. Semin Ophthalmol
2010; 25(5-6):239-243.

120. Ciralsky J, Papaliodis GN, Foster CS, Dohlman CH, Chodosh J. Keratoprosthesis in
autoimmune disease. Ocul Immunol Inflamm 2010; 18(4):275-280.

121. Qian CX, Harissi-Dagher M. Delayed suprachoroidal hemorrhage following Boston

Keratoprosthesis in two aniridic patients. Br J Ophthalmol 2011; 95(3):436-437.

122. Oliveira L, Cade F, Dohlman CH. Keratoprosthesis in the fight against corneal blindness
in developing countries. (Editorial) Arg Bras Oftalmol 2011; 74:5-6.

123. Harissi-Dagher M. Boston Keratoprosthesis: expanding the boundaries (editorial). Digit J

Ophthalmol 2011; 17(4):53-54.

124. Kyrillos R, Harissi-Dagher M. A failed corneal graft as the carrier tissue for the Boston
keratoprosthesis Type I. Digit J Ophthalmol 2011; 17(4):72-73.

125. Kyrillos R, Harissi-Dagher M. Prolene Monofilament Suture in Boston Keratoprosthesis

Surgery. Digit J Ophthalmol 2011; 17(1):6-8.

126. Robert MC, Harissi-Dagher M. Boston Type I Keratoprosthesis: the CHUM experience.
Can J Ophthalmol 2011; 46:164-168.

127. Mousally K, Harissi-Dagher M. Long-term complications associated with glaucoma

drainage devices and Boston keratoprosthesis. Am J Ophthalmol 2011; 152:883-884.

128. Stacey RC, Jakobiec FA, Michaud NA, Dohlman CH, Colby KA. Characterization of
retro-keratoprosthetic membranes in the Boston Type I keratoprosthesis. Arch Ophthalmol
2011;1 29:310-316

129. Chodosh J, Dohlman CH. Indications for keratoprosthesis. In: Krachmer J, Mannis M,
Holland E, eds. Cornea 3rd ed., St. Louis; Mosby-Year Book, Inc.: 2011.Vol. II p.1689-
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130. Dohlman CH, Gelfand L, Walcott-Harris, R, Moar ML. Boston Keratoprosthesis Users
Manual 2011. Massachusetts Eye and Ear Infirmary, Boston.

131. Beyer J, Todani A, Dohlman CH. Visually debilitating deposits on soft contact lenses in
keratoprosthesis patients. Cornea 2011; 30:1419-1422

132. Ament JD, Stryjewski TP, Pujari S, Siddique S, Papaliodis GN, Chodosh J, Dohlman CH.
Cost effectiveness of the Type II Boston Keratoprosthesis. Eye 2011; 25:342-349

133. Cade F, Grossskreutz CL, Tauber A, Dohlman CH. Glaucoma in eyes with severe
chemical burn, before and after Boston Keratoprosthesis. Cornea 2011; 30:1322-1327.

134. Dohlman CH, Cade F, Pfister RR. Chemical burns to the eye: Paradigm shifts in treatment.
(Editorial) Cornea.2011; 30:613-614

135. Todani A, Ciolino JP, Ament JD, Colby KA, Pineda R, Belin MW, Aquavella JV, Graney
JM, Chodosh J, Dohlman CH. Titanium back plate for a PMMA keratoprosthesis: Clinical
outcomes. Graefe’s Arch for Clin and Exp Ophthalmol 2011; 249:1515-1518

136. Pujari S, Siddique S, Dohlman CH, Chodosh J. Boston Keratoprosthesis Type II: The
Massachusetts Eye and Ear Infirmary experience. Cornea 2011; 30:1298-1303

137. Li JY, Greiner MA, Brandt JD, Lim MC, Mannis MJ. Long-term complications associated
with glaucoma drainage devices and Boston Keratoprosthesis. Am J Ophthalmol 2011;
152:209-218.

138. Greiner MA, Li JY, Mannis MJ. Longer-term vision outcomes and complications with the
Boston Type I Keratoprosthesis at the University of California, Davis. Ophthalmology
2011; 118:1543-1550

139. Basu S, Taneja M, Sangwan V. Boston Type I Keratoprosthesis for severe blinding vernal
keratoconjunctivitis and Mooren’s ulcer. Int Ophthalmol 2011; 31:219-222

140. Haddadin R, Dohlman CH. Keratoprosthesis in congenital hereditary endothelial

dystrophy. DJO 2011;17

141. Utine CA, Tzu J, Dunlap K, Akpek EK. Visual and clinical outcomes of explanation
versus preservation of the intraocular lens during Boston Type I keratoprosthesis
implantation. J Cataract Refract Surg 2011; 37:1615-1622.

142. Utine CA, Tzu J, Akpek EK. Clinical features and outcomes of Boston Type I
Keratoprosthesis associated corneal melt. Ocul Immunol Inflamm 2011; 19:413-418.

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143. Banitt M. Evaluation and management of glaucoma after keratoprosthesis. Curr Opin
Ophthalmol 2011; 22:133-136.

144. Ciolino JB, Hudson SP, Mobbs AN, Hoare TR, Iwata N, Fink GR, Kohane DS. A
prototype antifungal contact lens. Invest Ophthalmol Vis Sci 2011; 52:6286-6291

145. Behlau I, Mukjerjee K, Todani A, Tisdale AS, Cade F, Wang L, Leonard EM, Zakka FR,
Gilmore MS, Jakobiec FA, Dohlman CH, Klibanov AM. Biocompatibility and biofilm
inhibition of N,N-hexyl, methyl-polyethylenimine bonded to Boston Keratoprosthesis
materials. Biomaterials 2011; 32:8783-8796.

146. Todani A, Behlau I, Fava M, Cade F, Cherfan D, Zakka FR, Jakobiec FA, Gao Y, Dohlman
CH, Melki S. Intraocular pressure measurement by radiowave telemetry. Invest
Ophthalmol Vis Sci 2011; 52:9573-9580.

147. Iyer G, Srinivasan B, Gupta J, Rishi P, Sen PR, Bhende P, Gopas L, Padmanabhan P.
Boston Keratoprosthesis for keratopathy in eyes with retained silicone oil – A new
indication. Cornea 2011; 30:1083-1087.

148. Jeong KJ, Wang L, Stefanescu CF, Lawlor M, Polat J, Dohlman CH, Langer RS, Kohane
DS. Polydopamine coatings for biointegration. Soft Matter 2011; 7:8305-8312.

149. Wang L, Jeong KJ, Chiang HH, Zurakowski D, Dohlman CH, Chodosh J. Langer RS,
Kohane DS. Hydroxyapatite for keratoprosthesis biointegration. Invest Ophthalmol Vis
Sci 2011; 52:7392-7399.

150. Chan CC, Holland EJ, Sawyer WI, Neff KD, Peterson MR, Riemann CD. Boston Type I
Keratoprosthesis with silicone oil for treatment of hypotony in prephthisical eyes. Cornea
2011; 30:1105-1109.

151. Sejpal K, YU F, Aldave AJ. The Boston Keratoprosthesis in the management of corneal
limbal stem cell deficiency. 2011; 30:1187-1194.

152. Verdejo-Gómez L, Peláez N, Gris O, Güell JL. The Boston Type I Keratoprosthesis: An
assessment of its efficacy and safety. Ophthalmic Surg Lasers Imaging 2011; 42:446-452.

153. Guell JL, Arcos E, Gris O, Aristizabal D, Pacheco M, Sanchez CL, Manero F. Outcomes
with the Boston Type I keratoprosthesis at Instituto de Microcirugia Ocular IMO. Saudi J
Ophthalmology 2011; 25:281-284.

154. Yu JF, Huang YF. Keratoprosthesis in China. Ophthalmology 2011; 118:1486.

155. Yu JF, Liang L, Huang Y. Keratoprosthesis Surveillance Cultures. Letter to the Editor.
Ophthalmology 2012; 119:202-203.

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156. Yu JF, Huang YF. Characteristics of endophthalmitis with Boston keratoprosthesis.

Cornea 2012; 31:594.

157. Soledad Cortina M, Porter IW, Sugar J, de la Cruz J. Boston Type I keratoprosthesis for
visual rehabilitation in a patient with gelatinous drop-like corneal dystrophy. Cornea 2012;
31:844-845.

158. Robert MC, Biernacki K, Harissi-Dagher, M. Boston Keratoprosthesis Type I Surgery: Use
of Frozen Versus Fresh Corneal Donor Carriers. Cornea 2012; 31:339-345.

159. Rudnisky CJ, Belin MW, Todani A, Zerbe BJ, Ciolino JB. Risk factors for the
development of retroprosthetic membranes with Boston Keratoprosthesis Type I:
multicenter study results. Ophthalmology 2012; 119:951-955.

160. Chan CC, Holland EJ. Infectious endophthalmitis after Boston Type I Keratoprosthesis
implantation. Cornea 2012; 31:346-349.

161. Chan CC, Holland EJ. Infectious Keratitis after Boston Type I Keratoprosthesis
implantation. Cornea 2012; 31:1128-1134.

162. Ramchandran RS, DiLoreto DA, Chung MM, Kleinman DM, Plotnik RP, Graman P,
Aquavella JV. Infection endophthalmitis in adult eyes receiving Boston Type I
keratoprosthesis. Ophthalmology 2012;119:674-681.

163. Kamyar R, Weizer JS, dePaula FH, Stein JD, Morai SE, John D, Musch D, Mian S.
Glaucoma associated with Boston Type I keratoprosthesis. Cornea 2012; 31:134-139.

164. Kumar R, Dohlman CH, Chodosh J. Oral acetazolamide after keratoprosthesis in Stevens-
Johnson Syndrome. BMC Research Notes 2012; 5:205.

165. Dokey A. Ramulu PR, Utine CA, Tzu JH, Ebhart CG, Shan S, Gehlbach PL, Akpek EK.
Chronic hypotony associated with the Boston Type I Keratoprosthesis. Am J Ophthalmol
2012; 154:266-271.

166. Akpek EK, Aldave AJ, Aquavella JV. The use of precut, γ-irradiated corneal lenticules in
Boston Type I keratoprosthesis implantation. Am J Ophthalmol 2012; 154:495-498.

167. Bakhtiari P, Chan C, Welder JD, de la Cruz J, Holland EJ, Djalilian AR. Surgical and
visual outcomes of the Type I Boston Keratoprosthesis for the management of aniridic
fibrosis syndrome in congenital aniridia. Am J Ophthalmol 2012; 153:967-971.

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168. Patel S, Takusagawa H, Shen L, Dohlman CH, Grosskreutz C. Long-term complications

associated with glaucoma drainage devices and Boston Keratoprosthesis. Am J
Ophthalmol 2012; 154:207-208.

169. Kang JJ, Allemann N, Cortina MS, de la Cruz J, Aref AA. Argon laser iridopplasty for
optic obstruction of Boston keratoprosthesis. Arch Ophthalmol 2012; 130:1051-1054.

170. Kang JJ, de la Cruz J, Soledad Cortina MS. Visual outcomes of Boston Keratoprosthesis
implantation as the primary penetrating corneal procedure. Cornea. 2012; 31:1436-1440.

171. Hou JH, Cruz JD, Djalilian AR. Outcomes of Boston Keratoprosthesis implantation for
failed keratoplasty after keratolimbal allograft. Cornea 2012; 31:1432-1435.

172. Robert MC, Moussally K, Harissi-Dagher M. Review of endophthalmitis following Boston

keratoprosthesis type I. Br J Ophthalmol 2012; 96:776-780.

173. Pineda R. Introducing new technology with an eye on sustainability. Humanitarian

Outreach. Advanced Ocular Care 2012; March/April:60-62.

174. Aldave AJ, Sangwan VS, Basu S, Basak SK, Hovakimyan A, Gevorgyan O, Al Kharashi S,
Al Jindan M, Tandon R, Mascarenhas J, Malyugin B, Padilla, MDB, Maskati Q, Agarwala
N, Hutauruk J, Sharma M, Yu F. International results with the Boston Type I
Keratoprosthesis. Ophthalmology 2012; 119:1530-1538.

175. Kiang L, Rosenblatt MI, Sartaj R, Fernandez AG, Kiss S, Radcliffe NM, D’Amico DJ,
Sippel KC. Surface epithelialization of the type I Boston keratoprosthesis front plate:
immunohistochemical and high-definition optical coherence tomography characterization.
Graefes Arch Clin Exp Ophthalmol 2012; 250:1195-1199.

176. Kiang L, Sippel KC.Starr CE, Ciralsky J, Rosenblatt MI, Radcliffe NM, D’Amico DJ, Kiss
S. Vitroretinal surgery in the setting of permanent keratoprosthesis. Arch Ophthalmol
2012; 130:487-492.

177. Iyer G, Srinivasan B, Agarwal S, Barbhaya. Visual rehabilitation with keratoprosthesis

after tenoplasty as the primary globe-saving procedure for severe ocular chemical injuries.
Graefes Arch Clin Exp Ophthalmol 2012; 250:1787-1793.

178. Iyer G, Srinivasan B, Gupta N, Padmanabhan P. Outcome of Boston Keratoprosthesis in a

Developing Country-Importance of patient selection, education, and perioperative care:
The Indian experience. Asia-Pacific J Ophthalmol 2012; 1:202-207.

179. Chen JL, Shen TT, Brady J, Herlihy EP. Strabismus surgery in a patient with a Boston K-
Pro keratoprosthesis. J Am Assoc Pediatr Ophthalmol Strabismus 2012; 16:476-477.

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180. Wang L, Huang Y, Gong Y, et al. Role of autologous corneas as a carrier for the Boston
Keratoprosthesis. Chinese J Optometry Ophthalmol Vis Sci 2012; 14(8): 453-456.

181. Shihadeh WA, Mohidat HM. Outcomes of the Boston Keratoprosthesis in Jordan. Middle
East Afr J Ophthalmol 2012; 19(1):97-100.

182. Al Arfaj K, Hantera M. Short-term visual outcomes of Boston Keratoprosthesis Type I in

Saudi Arabia. Middle East Afr J Ophthalmol 2012; 19(1):88-92.

183. Vora, GK, Colby KA. Management of glaucoma following Boston Keratoprosthesis.
European Ophthalmic Review 2012; 6:214-217.

184. Bajracharya L, Gurung R, Tabin G. Keratoprosthesis, Dohlman Type I device for a patient
with repeated corneal graft failure. Nepal J Ophthalmol 2012; 4(7):165-169.

185. Magalhães FP, Sousa LB, Oliveira LA. Boston Type I keratoprosthesis. Review. Arq
Bras Oftalmol 2012; 75(3):218-222.

186. Talajic JC, Agoumi Y, Gagné S, Mousally K, Harissi-Dgher M. Prevalence, progression

and impact of glaucoma on vision after Boston Type I keratoprosthesis surgery. Am J
Ophthalmol 2012; 153:267-274.

187. Dutta J, Mukhopadhyay S, Data H, Sen S. Boston keratoprosthesis restoring vision in an

unusual case of end-stage limbal stem cell deficiency following exposure to Euphorbia
latex. Int Ophthalmol 2012; 32:77-79.

188. Keating A, Pineda R. Trichosporon asahii keratitis in a patient with a Type I Boston
keratoprosthesis and contact lens. Eye & Contact Lens 2012; 38:130-132.

189. Ramcharan RS, DiLoreto DA, Chung MM, Kleinman DM, Plotnik RP, Graman P,
Aquavella JV. Infectious endophthalmitis in adult eyes receiving Boston Type I
keratoprosthesis. Ophthalmology 2012; 119:674-681.

190. Patel AP, Wu EI, Ritterband DC, Seedor JA. Boston Type I keratoprosthesis: the New
York Eye and Ear experience. Eye 2012; 26:418-425.

191. Chen JQ, Zhai JJ, Gu JJ, Shao YF, Liu YM, Yuan J, Zhou SY. Preliminary study of
Boston keratoprosthesis in treatment of severe late stage ocular chemical burns. Zhonghua
Yan Ke Za Zhi 2012; 48(6):537-541.

192. Robert MC, Moussally K, Harissi-Dagher M. Review of endophthalmitis following Boston

keratoprosthesis type 1. Br J Ophthalmol 2012; 96:776-780.

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193. Magalhães FP, Nascimento HM, Ecker DJ, Sannes-Lowery KA, Sampath R, Rosenblatt
MI, Barbosa de Sousa L, Augusto de Oliveira L. Microbiota evaluation of patients with a
Boston Type I Keratoprosthesis treated with topical 0.5% moxifloxacin and 5% providone-
iodine. Cornea 2013; 32:407-411.

194. Rai R, Shorter E, Cortina MS, McMahon T, Cruz JD. Contact Lens Surveillance Cultures
in Boston Type I keratoprosthesis patients. Eye Contact Lens 2013; 39:175-178.

195. Goldman DR, Hubschman J, Aldave AJ, Chiang A, Huang JS, Bourges J, Schwartz SD.
Postoperative Posterior Segment Complications in Eyes Treated With the Boston Type I
Keratoprosthesis. Retina 2013; 33: 532-541.

196. Sivaraman KR, Hou JH, Alleman N, de la Cruz J, Cortina MS. Retroprosthetic membrane
and risk of sterile keratolysis in patients with type I Boston keratoprosthesis. Am J
Ophthalmol 2013; 155:814-822.

197. Kim MJ, Bakhtiari P, Aldave AJ. The international use of the Boston type 1
keratoprosthesis. Int Ophthalmol Clin 2013; 53:79-89.

198. Robert MC, Pomerleau V, Harissi-Dagher. Complications associated with Boston

keratoprosthesis type I and glaucoma drainage devices. Br J Ophthalmol 2013; 97:573-577.

199. Adesena O, Vickery J, Ferguson C, Stone D. Stromal melting associated with a cosmetic
contact lens over a Boston Keratoprosthesis: Treatment with a conjunctival flap. Eye
Contact Lens, May 2013: 39;e 4-6.

200. Rixen JJ, Cohen AW, Kitzmann AS, Wagoner MD, Goins KM. Treatment of Aniridia with
Boston Type I Keratoprosthesis. Cornea 2013; 32:947-950.

201. Shapiro BL, Cortés DE, Chin EK, Li JY, Werner JS, Redenbo E, Mannis MJ. High-
resolution Spectral Domain Anterior Segment Optical Coherence Tomography in Type I
Boston Keratoprosthesis. Cornea 2013; 32:951-955.

202. Palioura S, Kim B, Dohlman CH, Chodosh J. Boston Keratoprosthesis Type I in mucous
membrane pemphigoid. Cornea 2013; 32:956-961.

203. Paschalis EI, Chodosh J, Spurr-Michaud S, Cruzat A, Tauber A, Behlau I, Gipson I,

Dohlman CH. In vitro and in vivo assessment of titanium surface modification for coloring
the back plate of the Boston keratoprosthesis. Invest Ophthalmol Vis Sci 2013; 54:3863-
3873.

204. Harissi-Dagher M, Durr GM, Biernacki K, Sebag M, Rhéaume MA. Pars plana vitrectomy
through the Boston keratoprosthesis type 1. Eye 2013; 27:767-769.

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205. Ciolino JB, Belin MW, Todani A, Al-Arfaj K, Rudnisky CJ, Boston Keratoprosthesis Type
1 Study Group. Retention or the Boston Keratoprosthesis Type 1. Multicenter Study
Results. Ophthalmology 2013; 120:1195-1200.

206. Muñoz-Gutierrez G, Alvarez de Toledo J, Barraquer RI, Vera L, Couto Valeria R, Nadal J,
de la Paz MF. Post-surgical outcome and complications in Boston Type I Keratoprosthesis.
Arch Soc Esp Oftalmol 2013; 88:56-63.

207. Mori Y, Nejima R, Minami K, Miyata K, Kamiya K, Fukud M. Long-term outcomes of

Boston Keratoprosthesis. Nihon Ganka Gakkai Zasshi 2013, 117:35-43.

208. Sayegh R, Dohlman CH. Wide-angle fundus imaging through the Boston Keratoprosthesis.
Retina 2013; 33:1188-1192.

209. Sivaraman KR, Aakalu VK, Sajja K, Cortina MS, de la Cruz J, Setabutr P. Use of a Porous
Polyethylene Lid Spacer for Management of Eyelid Retraction in Patients with Boston
Type II Keratoprosthesis. Orbit 2013; 32:247-249.

210. D’Amico DJ. New Methods for Retinal Examination in Eyes with a Boston
Keratoprosthesis. Editorial. Retina 2013; 33:1097-1098.

211. Rachitskaya AV, Moysidis SN, Miller D, Perez VL, Banitt MR, Alfonso EC, Parel JM,
Berrocal AM. Streptococcal Endophthalmitis in Pediatric Keratoprosthesis. Report.
Ophthalmology 2013; 120:1506.

212. Feng MT, Burkhart ZN, McKee Y, Price FW. A technique to rescue keratoprosthesis
melts. Cornea 2013; 32:1407-1411.

213. Kang JJ, Allemann N, de la Cruz J, Soledad Cortina M. Serial analysis of anterior chamber
depth and angle status using anterior segment optical coherence tomography after Boston
Keratoprosthesis. Cornea 2013; 32:1369-1374.

214. Robert MC, Eid EP, Saint-Antoine P, Harissi-Dagher M. Microbial Colonization and
Antibacterial Resistance Patterns after Boston Type I Keratoprosthesis. Ophthalmology
2013, 120:1521-1528.

215. Zellander A, Gemeinhart R, Djalilian A, Makhsous M, Sun S, Cho M. Designing a gas

foamed scaffold for keratoprosthesis. Mater Sci Eng C Mater Biol Appl 2013; 33(6):3396-
3403.

216. Ziai S, Rootman DS, Slomovic AR, Chan CC. Oral buccal mucous membrane allograft
with corneal lamellar graft for the repair of Boston type I keratoprosthesis stromal melt.
Cornea 2013; 32:1516-1519.

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 October 2013

217. Zellander A, Wardlow M, Djalilian A, Zhao C, Abiade J, Cho M. Engineering

copolymeric artificial cornea with salt parogen. J Biomed Mater Res Part A
2013:00A:000-000.

218. Ying D, Yang J, Wang L, Ma X, Huang Y, Qiu Z, Cui F. An improved biofunction of

titanium for keratoprosthesis by hydroxyapatite coating. J Biomater Appl 2013 in press.

219. Wang L, Huang Y, Chodosh J, Dohlman CH. Boston Keratoprosthesis in China (in
Chinese). ZhongHua YanKe ZaZhi. in press.

220. Kammerdiener LL, Aquavella JV, Harissi-Dagher M, Lynch ML, Dohlman CH, Chodosh
J, Ciolino J. Soft contact lens retention after Boston Keratoprosthesis:The importance of
preoperative diagnosis. Am J Ophthalmol. in press

221. Magalhães FP, Hirai FE, de Sousa LB, de Oliveira LB. Boston type I keratoprosthesis
outcomes in ocular burns. Acta Ophthalmol 2013; 91:e432-436.

222. Cruzat A, Tauber A, Shukla A, Paschalis E, Pineda R, Dohlman CH. Low-cost and readily
available tissue carriers for the Boston Keratoprosthesis: a review of possibilities. J
Ophthalmol 2013, in press.

223. Gonzalez-Saldivar G, Lee NG, Chodosh J, Freitag SK, Stacy RC. Dacryops in the setting
of a Boston type II keratoprosthesis. Ophthal Plast Reconstr Surg 2013, in press.

224. Arafat SN, Shukla AN, Dohlman CH, Chodosh J, Ciolino JB. Crosslinked cornea:
Keratoprosthesis carriers more resistant to keratolysis. Submitted to IOVS

225. Chang HP, Luo ZK, Chodosh J, Dohlman CH, Colby KA. Primary Type I Boston
keratoprosthesis in non-autoimmune corneal diseases. Submitted to Cornea.

226. Crnej A, Paschalis EI, Salvador B, Tauber A, Shen L, Dohlman CH. Glaucoma
progression and role in patients with Boston keratoprosthesis. To be submitted to Cornea.

227. Cade F, Paschalis EI, Regatieri CV, Vavvas D, Dana R, Dohlman CH. Alkali burn to the
eye: Protection using TNF-α inhibition. To be submitted to Cornea.

228. Behlau I, Martin KV, Martin JN, Naumova EN, Cadorette JJ, Sforza JT, Dohlman CH.
Boston keratoprosthesis infectious endophthalmitis: Incidence and prevention. Submitted
to Arch Ophthalmol.

229. Paschalis EI, Chodosh J, Sperling RA, Dohlman CH. A novel implantable glaucoma valve
using ferrofluid. PLoS ONE 2013; in press.

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 October 2013

230. Salvador-Culla B, Behlau I, Sayegh RR, Stacy RC, Dohlman CH, Delori F. Light-induced
maculopathy after Boston keratoprosthesis surgery? Submitted to Cornea.

231. Arafat SN, Suelves AM, Spurr-Michaud S, Chodosh J, Foster CS, Dohlman CH, Gipson
IK. Neutrophil collagenase, gelatinase B and myeloperoxidase in tears of Stevens-Johnson
syndrome and mucous membrane pemphigoid patients. Ophthalmology 2013, in press.

232. Chen __, Jiaqi __, Gu __, Jianjun __, Zhai __, Jiajie __. The Boston Keratoprosthesis
surgery with fresh versus autologous corneal carriers in severe chemical burns: a
prospective controlled pilot study. Submitted to BJO

233. Cruzat A, Shukla A, Dohlman CH, Colby KA. Wound anatomy following Type I Boston
Keratoprosthesis using oversized back plates. Cornea 2013.

234. Kim MJ, Yu F, Aldave AJ. Microbial Keratitis after Boston Type I Keratoprosthesis
Implantation: Incidence, Organism, Risk Factors, and Outcomes. Ophthalmology 2013, in
press.

235. Ciolino JB, Stefanescu CF, Ross AE, Salvador B, Cortez P, Ford EM, Wymbs KA,
Sprague SL, Mascoop DR, Rudina SS, Trauger SA, Cade F, Kohane DS. In vivo
performance of a drug-eluting contact lens to treat glaucoma for a month. Biomaterials
2013; (in press)

236. Paschalis E, Cade F, Melki S, Pasquale LR, Dohlman CH, Ciolino J. Reliable intraocular
pressure measurement using automated radiowave telemetry.

237. Iyer, G. Structural & Functional Rehabilitation In eyes with Lamina Resorption following
MOOKP: Can the lamina be salvaged? Grafes Arch Clin and Exp Ophthalmol

238. Lee SH, Mannis MJ, Shapiro B, Li JY, Polage C, Smith W. Evaluation of Microbial Flora
in Eyes with a Boston Type I Keratoprosthesis. Cornea 2013, in press.

239. Fadlallah A, Jakobiec FA, Mendoza PR, Zalloua PA, Melki SA. Boston Type I
Keratoprosthesis of Treatment of Gelatinous Drop-like Corneal Dystrophy after Repeated
Graft Failure. Semin Ophthalmol 2013; in press.

240. Poddar R, Cortés DE, Werner JS, Mannis MJ, Zawadzki RJ. Three-dimensional anterior
segment imaging in patients with type I Boston Keratoprosthesis with switchable full depth
range swept source optical coherence tomography. J Biomed Opt 2013; in press.

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