Abstract: Objective To evaluate the outcomes of Boston type Ⅰ keratoprosthesis implantation by anterior segment optical coherence tomography (AS-OCT). Methods Clinical data about 31 patients (31 eyes) who received Boston type Ⅰ keratoprosthesis in the eye center of the First Medical Center of Chinese PLA General Hospital from February 2007 to June 2018 were reviewed retrospectively.There were 26 males and 5 females with the age ranging from 18 to 71 years.The BCVA was recorded and the AS-OCT examination results at different timepoints after operation were analyzed. Results Type Ⅰ Boston keratoprosthesis was successfully implanted in all the cases and followed up for 1 year.Preoperative vision in 31 cases (31 eyes) was light perception or hand move,and the postoperative BCVA ranged from 0.05 to 0.8,with average of 0.41±0.25.At 1 week,1 month,3 months,6 months and 12 months after operation,the BCVA did not changed significantly (P=0.779).According to AS-OCT,the anterior membrane of artificial cornea was found in 7 cases (7/31,22.6%) since 1 month after operation,and 1 case underwent anterior membrane of artificial cornea resection at 6 months after operation.The KPro corneal melt was found locally in 6 cases (6/31,19.4%) from 3 months to 6 months after operation,and all of them underwent repair operation (2 cases underwent repair operation at 3 months after operation,3 cases at 6 months after operation,1 case at 9 months after operation). Conclusion The incidence of complications is high in the first year after Boston type Ⅰ keratoprosthesis.AS-OCT is an effective tool to observe the KPro corneal melt and the growth of anterior membrane of artificial cornea,and provides evidence for timely treatment of complications,so as to stabilize the BCVA after operation.