Cataract extraction after implantation of a type I Boston keratoprosthesis

Purpose: To describe cataract extraction and intraocular lens placement in a patient with an existing Type I Boston keratoprosthesis. Methods: Case report to describe the surgical technique used to remove a cataract that developed after Boston keratoprosthesis placement. Results: Extracapsular cataract extraction by using an open-sky technique can be used to remove a cataractous lens in the setting of an existing Boston keratoprosthesis. Conclusions: Although this case shows that it is possible to per-form cataract surgery after Boston keratoprosthesis placement, it is prudent to remove the crystalline lens during the initial surgery, even in the absence of a visually significant cataract, because several factors work together to almost guarantee eventual cataract development if the patient is left phakic.