1. EXPERIENCE WITH A PMMA KERATOPROSTHESIS AT THE FEDERAL UNIVERSITY OF SAO PAULO, BRASIL Oliveira LA, M.D; Sousa LB, M.D; Hofling-Lima AL, M.D; Freitas D, M.D; Belfort R Jr, M.D. Authors have no financial interest.

2. PURPOSE To report the Federal University of São Paulo experience with a PMMA keratoprosthesis (Boston Type I)

3. METHODS Study design: chart review of 16 eyes of 16 patients who underwent Boston type I K-pro surgery between 2008 and 2010 Preoperative, intraoperative, and postoperative parameters were analyzed, including visual acuity and keratoprosthesis stability All surgeries were performed by the same surgeon: LAO

4. RESULTS Preoperative diagnosis - Chemical injury: 8 eyes (50%) - Failed graft: 8 eyes (50%) Preoperative glaucoma - 9 eyes (56.25%) Preoperative BCVA - ranged from 20/400 – light perception

5. RESULTS Average follow-up - 17 months (1-25m) Postoperative visual acuity - ≥ 20/200: 75% - ≥ 20/200: 70% (at least 1 year postop) - ≥ 20/40: 30% (at least 1 year postop) Retention rate - 93.75% (mean follow-up 17 months)

6. MAIN COMPLICATIONS Retroprosthetic membrane - 4 eyes (25%) IOP increase - 4 eyes (25%) Retinal detachment - 1 eye (6.25%) Infection (keratitis) - 1 eye (6.25%) Extrusion - 1 eye (6.25%)

7. DiagnoseGlaucoma pre- op VA pre-op ComplicationsFollow-upVA post- op 01Chemical burnYes (Trab)PLMelting25 MCF 50cm 02Multiple graft failureYes (clinical)20/400-25 M20/30p 03Chemical burnNoHMEpithelial defect Infectious keratitis 24 M20/100 04Multiple graft failureYes (clinical)LP-23 M20/30p 05Multiple graft failureYes (Ahmed)LPRetinal detachment20 MLP 06Chemical burnNoLPPerforation - extrusion 20 M20/100 07Chemical burnYes (clinical)20/400-19 M20/80 08Multiple graft failureYes (Ahmed)LP-19 M20/200 09Multiple garft failureYes (Ahmed)CF 0.5m-16 M20/30 10Chemical burnNoLPEpithelial defect13 M20/100 11Chemical burnYesLP-10 M20/100 12Chemical burnNoCF 0.5m-09M20/40 13Multiple garft failureNoCF 1m-07M20/40 14Multiple garft failureNo20/400-06M20/200 15Chemica burnYesMMHypotony03M20/50 16Multiple graft failureNoCF 2m-01M20/100 TABLE OF RESULTS

8. CONCLUSIONS This PMMA keratoprosthesis is a viable option in conditions with a poor prognosis for primary keratoplasty as in chemical injury and multiple keratoplasty failures The UNIFESP experience seems equivalent to previous reports regarding the complications rates as well as the anatomic and functional outcomes. Zerbe BL. Ophthalmology 2006. Bradley J. Cornea 2009.