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Keratoprosthesis

  • Chapter
Book cover Cornea and External Eye Disease

Part of the book series: Essentials in Ophthalmology ((ESSENTIALS))

  • 1287 Accesses

Core Messages

  • Despite the widespread use of standard keratoplasty, there continues to be a worldwide need for alternative therapies due to:

    1. (a)

      Substantial rates of graft failure on long-term follow-up

    2. (b)

      Poor prognosis in patients with underlying inflammation or chemical burns

    3. (c)

      Limited access to resources including donor tissue

  • Experience with keratoprosthesis (Kpro) has grown rapidly over the past two decades, and has resulted in improved outcomes and decreased complications for a large number of patients.

  • A key lesson learned is that long-term prognosis is linked to underlying diagnosis.

  • Kpro patients should be divided into two categories and examined separately:

    1. (a)

      In patients who have experienced failed grafts for corneal dystrophies, trauma, and infection, but lack underlying severe ocular inflammation, Kpro has yielded promising results in terms of device retention and improved visual acuity.

    2. (b)

      In patients with cicatrizing autoimmune diseases and chemical burns, the prognosis for Kpro has been more guarded.

  • A variety of Kpro designs are currently in use, and may have specific applications based on underlying patient subtype.

  • Assessment of current and future Kpro technology should account for this prognostic hierarchy.

  • Experimental “biologic” designs that aim to better integrate Kpro material with corneal tissue wcom-plications, but are yet to be proven.

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References

  1. Aldave AJ, Kamal KM, Vo RC et al (2009) The Boston type 1 keratoprosthesis: improving outcomes and expanding indications. Ophthalmology 116:640–651

    Article  PubMed  Google Scholar 

  2. Andel P, Worst J, Singh I (1993) Results of champagne cork keratoprosthesis in 127 corneal blind eyes. Refract Corneal Surg 9:189–190

    Google Scholar 

  3. Aquavella J V, Gearinger MD, Akpek EK et al (2007) Pediatric keratoprosthesis. Ophthalmology 114:989–994

    Article  PubMed  Google Scholar 

  4. Asworth JL, Rhatigan M, Sampath R et al (1996) The hydroxyapatite orbital implant: a prospective study. Eye 10(Pt 1):29–37

    Google Scholar 

  5. Bersudsky V, Blum-Hareuveni T, Rehani U et al (2001) The profile of repeated corneal transplantation. Ophthalmology 108:461–469

    Article  CAS  PubMed  Google Scholar 

  6. Bishop VL, Robinson L P, Wechsler AW et al (1986) Corneal graft survival: a retrospective Australian study. Aust N Z J Ophthalmol 14:133–138

    Article  CAS  PubMed  Google Scholar 

  7. Bradley JC, Hernandez EG, Schwab IR et al (2009) Boston type 1 keratoprosthesis: the University of California Davis experience. Cornea 28:321–327

    Article  PubMed  Google Scholar 

  8. Ciolino JB, Ament J W, Zerbe BL et al (2008) Etiology of keratoprosthesis loss: results from the Boston keratopros-thesis multicenter study. Invest Ophthalmol Vis Sci 49:E-Abstract 5712

    Google Scholar 

  9. Ciolino JB, Dohlman CH (2009) Biologic keratoprosthesis materials. Int Ophthalmol Clin 49:1–9

    Article  PubMed  Google Scholar 

  10. Dandona L, Naduvilath TJ, Janarthanan M et al (1997) Survival analysis and visual outcome in a large series of corneal transplants in India. Br J Ophthalmol 81:726–731

    Article  CAS  PubMed  Google Scholar 

  11. Doane MG, Dohlman CH, Bearse G (1996) Fabrication of keratoprosthesis. Cornea 15:179–184

    Article  CAS  PubMed  Google Scholar 

  12. Dohlman CH (1994) Keratoprostheses. In: Albert D, Jakobiec FJ (eds) Principles and practice of ophthalmology. WB Saunders, Philadelphia, PA, pp 338–342

    Google Scholar 

  13. Dohlman CH, Harissi-Dagher M, Khan BF et al (2006) Introduction to the use of the Boston Keratoprosthesis. Expert Rev Ophthalmol 1:41–48

    Article  Google Scholar 

  14. Dohlman CH, Barnes S, Ma J (2007) Keratoprosthesis. In: Krachmer JH, Mannis MJ, Holland EJ (eds) Cornea. CV Mosby, St. Louis, MO, pp 1719–1728

    Google Scholar 

  15. Dohlman CH, Schneider HA, Doane MG (1974) Prostho-keratoplasty. Am J Ophthalmol 77:694–700

    CAS  PubMed  Google Scholar 

  16. Dohlman CH, Terada H (1998) Keratoprosthesis in pem-phigoid and Stevens-Johnson syndrome. Av Exp Med Biol 438:1021–1025

    CAS  Google Scholar 

  17. Eye Bank Association of America. Eye banking statistical report. Eye Bank Association of America 2007, Washington DC,USA

    Google Scholar 

  18. Falcinelli G, Falsini B, Taloni M et al (2005) Modified oste-odonto-keratoprosthesis for treatment of corneal blindness: long-term anatomical and functional outcomes in 181 cases. Arch Ophthalmol 123:1319–1329

    Article  PubMed  Google Scholar 

  19. Fenglan X, Yubao L, Xiaoming Y et al (2007) Preparation and in vivo investigation of artificial cornea made of nano-hydroxyapatite/poly (vinyl alcohol) hydrogel composite. J Mater Sci Mater Med 18:635–640

    Article  PubMed  Google Scholar 

  20. Griffith M, Hakim M, Shimmura S et al (2002) Artificial human corneas: scaffolds for transplantation and host regeneration. Cornea 21:S54–S61

    Article  PubMed  Google Scholar 

  21. Hicks CR, Crawford GJ, Dart JK et al (2006) AlphaCor: clinical outcomes. Cornea 25:1034–1042

    Article  PubMed  Google Scholar 

  22. Hicks CR, Crawford GJ, Lou X et al (2003) Corneal replacement using a synthetic hydrogel cornea, AlphaCor: device, preliminary outcomes and complications. Eye 17:385–392

    Article  CAS  PubMed  Google Scholar 

  23. Hille K, Grabner G, Liu C et al (2005) Standards for modi-fied osteoodontokeratoprosthesis (OOKP) surgery according to Strampelli and Falcinelli: the Rome-Viena Protocol. Cornea 24:895–908

    Article  PubMed  Google Scholar 

  24. Hille K, Hille A, Ruprecht KW (2006) Medium term results in keratoprostheses with biocompatible and biological haptic. Graefes Arch Clin Exp Ophthalmol 244:696–704

    Article  CAS  PubMed  Google Scholar 

  25. Huang YX, Li QH (2007) An active artificial cornea with the function of inducing new corneal tissue generation in vivo — a new approach to corneal tissue engineering. Biomed Mater 2:S121–S125

    Article  CAS  PubMed  Google Scholar 

  26. Khan BF, Harissi-Dagher M, Dohlman CH (2008) Keratoprosthesis. In: Albert DM, Miller JW (eds) Albert and Jakobiec's Principles and Practice of Ophthalmology, 3rd edn. WB Saunders, Philadelphia, PA, pp 895–903

    Google Scholar 

  27. Khan BF, Harissi-Dagher M, Khan DM et al (2007) Advances in keratoprosthesis: enhancing retention and prevention of infection and inflammation. Int Ophthalmol Clin 47:61–71

    Article  PubMed  Google Scholar 

  28. Lee MK, Lee SM, Lee JL et al (2007) Long-term outcome in ocular intractable surface disease with Seoul-type kerato-prosthesis. Cornea 26:546–551

    PubMed  Google Scholar 

  29. Leon CR, Barraquer JI Jr, Barraquer JI Sr (1997) Corraline hydroxyapatite keratoprosthesis in rabbits. J Refract Surg 13:74–78

    CAS  PubMed  Google Scholar 

  30. Liu C, Paul B, Tandon R et al (2005) The osteo-odonto-keratoprosthesis (OOKP). Semin Ophthalmol 20:113–128

    Article  PubMed  Google Scholar 

  31. Ma J, Dohlman CH (2005) Repeat Penetrating keratoplasty versus the Boston keratoprosthesis in graft failure. Int Ophthalmol Clin N Am 45:49–59

    Article  Google Scholar 

  32. Maguire MG, Stark W, Gottsch J (1994) Risk factors for corneal graft failure and rejection in the collaborative corneal transplantation studies (CTTS). Ophthalmology 101:1536–1547

    CAS  PubMed  Google Scholar 

  33. Mannis MJ (1999) Dohlman CH (2005) The artificial cornea: a brief history. In: Mannis MJ, Mannis AA (eds) Corneal Transplantation: A History of Profiles (Hirschberg History of Ophthalmology). JP Wayenborgh, Oostende, Belgium, pp 321–335

    Google Scholar 

  34. Marchi V, Ricci R, Pecorella I et al (1994) Osteo-odonto-keratoprosthesis. description of surgical technique with results in 85 patients. Cornea 13:125–130

    Google Scholar 

  35. Maskati QB, Maskati BT (2006) Asian experience with Pintucci keratoprosthesis. Indian J Ophthalmol 54(2): 89–94

    Article  PubMed  Google Scholar 

  36. Mehta JS, Futter CE, Sandeman SR et al (1997) Hydroxy-apatite promotes superior keratocyte adhesion and proliferation in comparison with current keratoprosthesis in rabbits. J Refract Surg 13:74–78

    Google Scholar 

  37. Michael R, Charoenrook V, Fideliz de la Paz M et al (2008) Long-term functional and anatomical results of osteo- and osteoodonto-keratoprosthesis. Graefes Arch Clin Exp Ophthalmol 246:1133–1137

    Article  PubMed  Google Scholar 

  38. Myung D, Duhamel PE, Cochran JR et al (2008) Development of hydrogel-based keratoprostheses: a materials perspective. Biotechnol Prog 24:735–741

    Article  CAS  PubMed  Google Scholar 

  39. Myung D, Farooqui N, Waters D et al (2008) Glucose-permeable interpenetrating polymer network hydrogels for corneal implant applications, a pilot study. Curr Eye Res 33:29–43

    Article  CAS  PubMed  Google Scholar 

  40. Netland PA, Terada H, Dohlman CH (1998) Glaucoma associated with keratoprosthesis. Ophthalmology 105:751–757

    Article  CAS  PubMed  Google Scholar 

  41. Nouri M, Terada H, Alfonso EC et al (2001) Endophthalmitis after keratoprosthesis: incidence, bacterial causes, and risk factors. Arch Ophthalmol 119:484–489

    CAS  PubMed  Google Scholar 

  42. Ohji M, Mandarino L, SundarRaj N et al (1993) Corneal epithelial cell attachment with endogenous laminin and fibronectin. Invest Ophthalmol Vis Sci 34:2487–2492

    CAS  PubMed  Google Scholar 

  43. Pellier de Quengsy G (1789) Precis ou cours d'operations sur la chirurgie des yeux. Didot, Paris

    Google Scholar 

  44. Pettit DK, Horbett TA, Hoffman AS et al (1990) Quantitation of rabbit corneal epithelial cell outgrowth on polymeric substrates in vitro. Invest Ophthalmol Vis Sci 31:2269–2277

    CAS  PubMed  Google Scholar 

  45. Pintucci S, Pintucci F, Caiazza S et al (1996) The Dacron felt colonizable keratoprosthesis: after 15 years. Eur J Ophthalmol 6:125–130

    CAS  PubMed  Google Scholar 

  46. Sayegh RR, Ang L P, Foster CP et al (2008) The Boston Keratoprosthesis in Stevens-Johnson Syndrome. Am J Ophthalmol 145:438–444

    Article  PubMed  Google Scholar 

  47. Strampelli B (1963) Keratoprosthesis with osteodontal tissue. Am J Ophthalmol 89:1029–1039

    Google Scholar 

  48. Sweeney DF, Xie RZ, Evans MD et al (2003) A comparison of biological coatings for the promotion of corneal epithe-lialization of synthetic surface in vivo. Invest Ophthalmol Vis Sci 44:3301–3309

    Article  PubMed  Google Scholar 

  49. Tan D, Tay A, Theng J et al (2008) Keratoprosthesis surgery for end-stage corneal blindness in Asian eyes. Ophthal mology 115:503–510

    Article  Google Scholar 

  50. Temprano J (1993) Keratoprosthesis with tibial autograft. Refract Corneal Surg 9:192

    Google Scholar 

  51. Thompson RW, Price MO, Boweers PJ et al (2003) Long term graft survival after penetrating keratoplasty. Ophthalmology 110:1396–1402

    Article  PubMed  Google Scholar 

  52. Tugal-Tutkun I, Akova YA, Foster CS (1995) Penetrating ker-atoplasty in cicatrizing conjunctival diseases. Ophthalmology 102:576–585

    CAS  PubMed  Google Scholar 

  53. Whitcher J P, Srinivasan M, Upadhyay MP (2001) Corneal blindness: a global perspective. Bull World Health Organ 279(3):214–221

    Google Scholar 

  54. Williams KA, Muehlberg SM, Lewis RF et al (1995) How successful is corneal transplantation? A report from the Australian corneal graft register. Eye 9:219–227

    PubMed  Google Scholar 

  55. World Health Organization (2004) Magnitude and causes of visual impairment. Fact sheet No. 282. http://www.who.int/mediacentre/factsheets/fs282/en/. Accessed on 5 Nov2009

  56. Yaghouti F, Nouri M, Abad JC et al (2001) Keratoprosthesis: preoperative prognostic categories. Cornea 20:19–23

    Article  CAS  PubMed  Google Scholar 

  57. Yakimenko S (1993) Results of a PMMA/titanium kerato-prosthesis in 502 eyes. Refract Corneal Surg 9:197–198

    Google Scholar 

  58. Yamagami S, Suzuki Y, Tsuru T (1996) Risk factors for graft failure in penetrating keratoplasty. Acta Ophthalmol Scand 74:584–588

    Article  CAS  PubMed  Google Scholar 

  59. Zerbe BL, Belin M W, Ciolino JB et al (2006) Boston ker-atoprosthesis study group: results from the multicenter Boston type I keratoprosthesis study. Ophthalmology 113:1779–1784

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Veterans Affairs Boston Healthcare System, Jamaica Plain, MA, USA

    Jason J. Jun, Donna E. Siracuse-Lee & Mary K. Daly

  2. Department of Ophthalmology, Boston University School of Medicine, Boston, MA, USA

    Donna E. Siracuse-Lee & Mary K. Daly

  3. Boston University Eye Associates Inc., Albany Street, Boston, MA, 02118, USA

    Mary K. Daly

  4. Massachusetts Eye and Ear Infi rmary, Harvard Medical School, MA, USA

    Claes H. Dohlman

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  1. Jason J. Jun
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  2. Donna E. Siracuse-Lee
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  4. Claes H. Dohlman
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Editors and Affiliations

  1. University Eye Hospital, Killianstraβe 5, Freiburg, 79106, Germany

    Thomas Reinhard (Professor and Chairman) (Professor and Chairman)

  2. Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD, United Kingdom

    Frank Larkin

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Jun, J.J., Siracuse-Lee, D.E., Daly, M.K., Dohlman, C.H. (2010). Keratoprosthesis. In: Reinhard, T., Larkin, F. (eds) Cornea and External Eye Disease. Essentials in Ophthalmology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-85544-6_10

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  • DOI: https://doi.org/10.1007/978-3-540-85544-6_10

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