الفهرس 
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Abstract
The Boston Keratoprosthesis (KPro) is currently the most widely used artificial cornea and is the surgical option of choice for corneal disease not amenable to standard penetrating keratoplasty or corneal transplant. Continued advances in design and superior postoperative care have resulted in improved outcomes and an exponential increase in the use of the device in recent years.
The two most commonly reported postoperative complications in eyes with the Boston KPro are retroprosthetic membrane (RPM) formation, and elevated intraocular pressure/glaucoma.
Several studies have shown that worsening of preexisting glaucoma and de novo glaucoma, are the leading cause of irreversible vision loss in eyes with KPro.
Retroprosthetic membrane formation is the most frequent complication after KPro implantation, with a reported incidence of 25–65 % of cases.
The purpose of this work is to study the association between the development of retroprosthetic membrane and the development of synechial angle closure as evidenced by AS-OCT in eyes with implanted Boston keratoprosthesis.
Fifteen eyes of 15 patients with documented preoperative open angle of anterior chamber met the inclusion criteria and were included in the study.
Eight eyes (53.3%) developed RPM, with a mean time to development of 24 months, all of which developed new or progressive synechial angle closure evidenced by AS-OCT either concurrently or sequentially after RPM development, except one eye that seems to have developed angle closure earlier than RPM after an episode of endophthalmitis that was successfully treated with intravitreal injection of antibiotics followed by pars plana vitrectomy. Mean time from detection of RPM to detection of new angle closure was 4 months with a range of 1 to 12 months. Of the 7 eyes without RPM formation, only one eye progressed to develop new angle closure (14.3%) and the rest maintained open angle status by AS-OCT. The one eye that developed angle closure without RPM did so after pars plana vitrectomy for macula off retinal detachment.
Fisher’s exact test was statistically significant for a positive association between RPM development and post-operative angle closure by AS-OCT (p < 0.05)
We hypothesize that RPM can creep into the peripheral anterior chamber and induce synehcial angle closure in a zip like fashion