Autoimmune Disease May Defeat Artificial Corneas

Autoimmune ocular surface disease significantly impacts Boston KPro outcomes. These eyes are at greater risk for prosthesis failure and vision loss. Photo: Brandon Ayres, MD. Click image to enlarge. Artificial corneas can provide restored vision to patients suffering from damaged corneal tissue or when a transplant isn’t an option. While sight-saving, these devices can sometimes fail for a variety of reasons, making identifying poor retention risks an important area of study. Raul E. Ruiz Lozano, MD, of Bascom Palmer, shared data from his group’s retrospective chart review on KPro outcomes in a presentation earlier this week at the 2026 ARVO Meeting in Denver. His group’s work revealed key risk factors for prosthesis failure and vision loss.The study included 206 eyes of 192 patients who received KPro surgery at Illinois Eye & Ear Infirmary. There was a cumulative total of 1,368 life-years for KPro implantation. Median follow-up was 67 months.The researchers found that 80% (164/206) of implants were retained at last follow-up, demonstrating a retention time of 6.17 years/KPro, while the remaining implants failed. Multivariable analysis showed that KPro retention failure was linked to younger age (<18 years), prior ocular surface reconstruction and autoimmune disease. Almost half of eyes experienced vision loss (96/206 eyes), with autoimmune disease as the only significant risk factor.A total of 53 eyes had follow-up data exceeding 10 years. Of these, 38 (72%) retained the KPro and 31 (58%) had vision loss. Autoimmune disease and limbal stem cell deficiency were linked to retention failure, but no significant factors were associated with vision loss in this group.The researchers reported the following complications: de novo glaucoma or glaucoma progression in 24 eyes (45%), KPro replacement in 22 eyes (42%), retroprosthetic membrane in 21 eyes (40%), retinal detachment in 14 eyes (26%) and endophthalmitis in 12 eyes (23%). Forty of 53 eyes (75%) achieved a best-ever visual acuity of >20/200 and 18 of these eyes (45%) maintained vision at the end of follow-up.Based on these findings, the researchers concluded that eyes with autoimmune ocular surface disease have a higher likelihood of KPro failure and vision loss, while eyes with more than a decade of follow-up had acceptable retention and vision preservation.Original abstracts ©2026 Association for Research in Vision and Ophthalmology. Click here for the source. Ruiz Lozano RE, Schwartz R, Setter NW, et al. Survival probability of Boston Type 1 Keratoprosthesis at 10 years. ARVO 2026 annual meeting. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.