Keratoprosthesis. Results, complications, and management

Area of Science:

• Ophthalmology
• Biomedical Engineering

Background:

• Keratoprosthesis implantation is a surgical option for severe corneal blindness.
• The Cardona device is a type of keratoprosthesis used in challenging cases.

Purpose of the Study:

• To evaluate the long-term visual outcomes and complication rates of the Cardona keratoprosthesis.
• To assess the functional benefits of this device in patients with severe visual impairment.

Main Methods:

• A retrospective study followed 31 patients implanted with the Cardona keratoprosthesis.
• Data collected included visual acuity, complications, and need for surgical revision over 1-84 months.

Main Results:

• One patient achieved 20/20 vision; 5 achieved counting fingers. 12/31 had 20/40 or better postoperatively, but only 5/31 maintained this long-term.
• Severe complications included retroprosthetic membrane (18/31), vitreitis (7/31), dislocation (5/31), extrusion (3/31), and endophthalmitis (5/31).
• 17/31 patients experienced functional visual improvement, but 15/31 required further surgery.

Conclusions:

• The Cardona keratoprosthesis can provide significant visual improvement for some patients with severe corneal disease.
• High complication rates necessitate careful patient selection and management.
• Long-term visual acuity maintenance remains a challenge, highlighting the need for improved keratoprosthesis designs and surgical techniques.