Osteokeratoprosthesis Using Tibial Bone: Surgical Technique and Outcomes

Area of Science:

• Ophthalmology
• Biomaterials Science
• Surgical Innovation

Background:

• Severe corneal disease necessitates advanced prosthetic solutions.
• Tibial bone autograft keratoprosthesis (KPro) offers an alternative for patients unsuitable for traditional corneal transplants.
• Evaluating long-term outcomes is crucial for patient selection and surgical refinement.

Purpose of the Study:

• To assess the anatomical and functional success rates of tibial bone autograft keratoprosthesis.
• To identify factors influencing the survival of this specialized ocular prosthesis.

Main Methods:

• Retrospective review of 113 patient charts undergoing tibial bone osteokeratoprothesis implantation.
• Kaplan-Meier survival analysis for anatomical (implant retention) and functional (visual acuity ≥0.05) success.
• Multivariate analysis to determine the impact of clinical factors on survival rates.

Main Results:

• 10-year anatomical survival rate was 53.5%; 10-year functional survival rate was 19.2%.
• Chemical burns showed better outcomes than autoimmune or infectious diseases; patient age was not significant.
• Complications occurred in 48.7% of patients, including extrusion, glaucoma, and retinal detachment.

Conclusions:

• Tibial bone KPro provides a viable, albeit limited, long-term vision restoration option for select patients.
• Approximately 50% of patients retain the prosthesis for 10 years, with a significant portion regaining useful vision.
• This procedure remains a critical option for patients with no alternative treatments for vision loss.