To the Editor:
—Langham and Maumenee,1 and Knowles2 suggested that the insertion of a thin, water-impermeable membrane deep into the cornea serves as a barrier to aqueous in bullous keratopathy. In our clinical experience with this procedure (seven cases), the overlying cornea dehydrates, but the posterior portion becomes cloudy from edema and scarring. To improve vision, it seemed logical to penetrate the anterior chamber behind the membrane. Therefore, a prosthesis consisting of a thin, flexible membrane with a transparent posterior solid cylinder was designed (Figure). In concordance with Cardona's findings,3 our cylinder projects beyond the posterior corneal surface which should prevent posterior overgrowth.Whereas earlier investigators have used methacrylate, our implant is made of transparent, flexible silicone (Dow Corning). This material was found nontoxic in animal experiments. At present, the implant has been used in five patients with bullous keratopathy (kindly referred by the Eye Service of
Brown SI, Dohlman CH. A BURIED CORNEAL PROSTHESIS. Arch Ophthalmol. 1963;70(5):736. doi:10.1001/archopht.1963.00960050738030
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