The use of a modified full‐thickness graft flap following Boston type I keratoprosthesis implantation in patients with advanced corneal melting

Purpose To evaluate a modified full‐thickness corneal graft technique as a remedial strategy for advanced corneal melting following Boston type I keratoprosthesis (KPro) implantation. Methods Eleven patients with significant corneal melting and >180° KPro exposure underwent corrective surgery. A donor graft, matching the primary transplant diameter and with a 3‐mm central aperture, was thinned circumferentially and positioned beneath the KPro optical cylinder after debridement of necrotic tissue. Results Over 6–12 months of follow‐up, globe integrity was preserved in all cases. Two patients required repeat procedures for recurrence. Visual acuity improved in five patients; in others, it remained stable or declined due to comorbidities. Conclusion The modified full‐thickness graft technique is a promising alternative for managing advanced corneal melting after Boston type I KPro. Further studies with larger cohorts and longer follow‐up are warranted.