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Keratoprosthesis: technique and instrumentation.

J K Harris, G N Rao, J V Aquavella

    Annals of Ophthalmology
    |May 1, 1984
    PubMed
    Summary
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    New instruments assist in keratoprosthesis surgery, a last resort for severe vision loss when keratoplasty fails. Careful patient selection and monitoring are crucial due to potential serious complications.

    Area of Science:

    • Ophthalmology
    • Surgical Instruments

    Background:

    • Keratoprosthesis surgery is indicated for eyes with severe vision impairment unresponsive to conventional treatments.
    • Limited treatment options exist for patients with end-stage ocular surface disease or corneal failure.

    Purpose of the Study:

    • To describe novel instruments designed to improve the handling and implantation of keratoprostheses.
    • To outline the indications and essential preoperative evaluations for keratoprosthesis surgery.

    Main Methods:

    • Development and description of specialized instruments for keratoprosthesis manipulation, lid stabilization, and corneal trephination.
    • Review of surgical indications, including poor visual acuity in both eyes and failure of keratoplasty.
    • Emphasis on preoperative assessment of retinal function and intraocular pressure.

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    Main Results:

    • New instruments facilitate precise manipulation and surgical steps in keratoprosthesis implantation.
    • While newer techniques reduce extrusion rates, significant complications persist, including retroprosthetic membrane, endophthalmitis, retinal detachment, and glaucoma.

    Conclusions:

    • Keratoprosthesis surgery, utilizing advanced instruments, offers a final treatment option for severe visual impairment.
    • Patient selection and vigilant monitoring for complications are paramount due to the procedure's inherent risks.