Most complications of a keratoprosthesis occur at the tissue-to-implant interface. The ideal prosthesis would eliminate this interface by having the tissue actually grow into the supporting material. We present a prospective clinical human study of a novel biocolonizable keratoprosthesis in 24 eyes of 24 patients.
To promote implant stability, the 9-mm—diameter haptic was fashioned using a custom-made microporous fluorocarbon with a 4-mm—diameter, 2.67-mm—long, central optic made of medical grade polymethylmethacrylate, giving a global visual field of 110° to 130°. Only bilaterally blind patients with untreatable corneal diseases were included in the study. The haptic was inserted into a lamellar pocket delaminated in the stroma, and the optic was positioned through a hole trephined in the central cornea.
The average follow-up was 15.7 months (range, 4 to 28 months). The host corneal fibroblasts penetrated and proliferated into the peripheral microporous fluorocarbon and provided anchorage between the cornea and prosthesis. Seventeen patients (70.8%) had visual acuity improvements. Mean corrected final visual acuity was 20/100 (range, 20/30 to 20/400). Five anatomic failures occurred in the first 6 months (three extrusions, one dislocation of the optic, and one endophthalmitis). We had one case (4.1%) of treatable glaucoma. We successfully removed four of five retroprosthetic membranes that had occurred. No retinal detachment occurred.
The biocompatible inert microporous polymer did not eliminate all mechanical complications associated with a keratoprosthesis.
Legeais J, Renard G, Parel J, Savoldelli M, Pouliquen Y. Keratoprosthesis With Biocolonizable Microporous Fluorocarbon HapticPreliminary Results in a 24-Patient Study. Arch Ophthalmol. 1995;113(6):757–763. doi:10.1001/archopht.1995.01100060083038
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