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Keratoprosthesis: a 12-year follow-up
Transactions. Section on Ophthalmology. American Academy of Ophthalmology and Otolaryngology
|March 1, 1977
Summary
Keratoprosthesis implantation offers initial visual improvement for severe eye conditions but long-term success is limited by complications. Refinements in surgical techniques and device design have reduced complications, though it remains a procedure for complex cases.
Area of Science:
- Ophthalmology
- Biomaterials Science
Background:
- Keratoprosthesis implantation is a surgical option for severe corneal diseases and visual impairment.
- Previous studies highlight variable long-term visual outcomes and significant complication rates.
Purpose of the Study:
- To review the long-term outcomes of keratoprosthesis implantation in 125 cases.
- To identify factors influencing visual acuity and complications.
- To assess the impact of surgical technique and device modifications on outcomes.
Main Methods:
- Retrospective review of 125 keratoprosthesis implantation cases.
- Analysis of diagnoses including chemical burns, anterior segment disease, aphakic bullous keratopathy, and trauma.
- Evaluation of visual acuity at different time points and complication rates.
Main Results:
- Initial visual acuity of 20/15 to 20/40 achieved in 30% of patients, decreasing to 13% at 12 years.
- Visual acuity of 20/50 to 20/200 achieved in 24% initially, falling to 17% at 12 years.
- Complications led to loss of good visual acuity; improvements noted with Dacron skirt, Cardona nut/bolt, scleral expander, and graft modifications.
Conclusions:
- Keratoprosthesis implantation can provide initial visual gains but requires careful patient selection for complex, 'desperate' cases.
- Surgical technique and device improvements have reduced complication rates.
- Long-term management necessitates experienced surgeons familiar with managing potential complications.