Dr.Yathish Shivanna, Dr.Thungappa Kugar, Dr.Rashmi Deshmukh
Keratoprosthesis is a surgical procedure where a diseased cornea is replaced with an artificial cornea. Use of the Boston Keratoprosthesis type-1 has grown significantly in the management of complex corneal blindness. Carrier-graft melt and infection are most common devastating complications of Boston keratoprosthesis type-1. Eyes with autoimmune diseases such as Stevens-Johnson syndrome, toxic epidermal necrolysis syndrome, and mucous membrane pemphigoid remain particularly vulnerable to corneal melt, leak, and extrusion. Currently main modality of treatment for severe carrier-graft melt or extrusion of keratoprosthesis is to replace the whole keratoprosthesis assembly with new set of Boston keratoprosthesis. This video depicts a case of Boston keratoprosthesis (performed for ocular cicatricial pemphigoid in 2010) with severe carrier graft keratolysis and perforation which was managed by explanting the keratoprosthesis, dismantling (unlocking), cleaning it with betadine solution and reassembling with a new corneal carrier graft a