Keratoprosthesis

Keratoprosthesis is a surgical procedure where a diseased cornea is replaced with an artificial cornea. This procedure is typically considered when standard corneal transplants are not viable or have failed. The artificial cornea used in keratoprosthesis is designed to restore vision in patients with severe corneal opacities or other corneal diseases.

History

The concept of keratoprosthesis dates back to the 18th century, but significant advancements were made in the 20th century. Early attempts were often unsuccessful due to complications such as infection and extrusion. Modern keratoprostheses have improved significantly with better materials and surgical techniques.

Types of Keratoprosthesis

There are several types of keratoprostheses, including:

• Boston Keratoprosthesis (Boston KPro): One of the most commonly used types, developed at the Massachusetts Eye and Ear Infirmary.
• AlphaCor: A synthetic cornea made from a flexible polymer.
• Osteo-odonto-keratoprosthesis (OOKP): A complex procedure that uses the patient's own tooth and surrounding bone to support the artificial cornea.

Indications

Keratoprosthesis is indicated in patients with severe corneal opacities or scarring that cannot be treated with conventional corneal transplants. Common conditions include:

• Stevens-Johnson syndrome
• Ocular cicatricial pemphigoid
• Severe chemical burns
• Multiple failed corneal grafts

Surgical Procedure

The surgical procedure for keratoprosthesis involves several steps:

1. Removal of the diseased cornea. 2. Preparation of the recipient bed. 3. Placement of the artificial cornea. 4. Securing the keratoprosthesis in place.

Postoperative care is crucial to monitor for complications such as infection, inflammation, and extrusion of the device.

Complications

While keratoprosthesis can restore vision, it is associated with several potential complications:

• Glaucoma
• Retinal detachment
• Infection
• Extrusion of the device

Postoperative Care

Patients require lifelong follow-up to monitor for complications. Regular use of antibiotics and anti-inflammatory medications is often necessary. In some cases, additional surgeries may be required to address complications.

See Also

• Corneal transplant
• Ophthalmology
• Visual impairment