Skip to main content
SpringerLink
Log in

Korea Seoul-Type KPro: Indications, Contraindications, and Surgical Techniques

  • Chapter
  • First Online:
Keratoprostheses and Artificial Corneas

Abstract

The Seoul-type keratoprosthesis (Seoul KPro) was designed for use in severe ocular surface disease and end-stage dry eyes. The advanced stages of Stevens-Johnson syndrome, chemical burn, and ocular cicatricial pemphigoid are primary indications for implanting Seoul KPro. The Seoul KPro consists of an optic portion made from polymethyl methacrylate, nonwoven polypropylene skirt for corneal fixation, and haptics of polypropylene for scleral fixation. The main difference between the conventional keratoprosthesis and Seoul KPro is the method of fixation. Seoul KPro uses a method of double fixation to the eyeball to improve its biostability. A corneal lamellar pocket is made after partial trephination of the central cornea. The Seoul KPro is placed into an eyeball after excising the central cornea and delivery of the nucleus with an anterior vitrectomy. Subsequently, both haptics go through each side of the sclera from the inside out at 3 mm away from the limbus using 10-0 polypropylene suture. The skirt is inserted into the previously prepared corneal pocket, and the polypropylene sutures of the haptics are tightly fixed to the sclera when the intraocular pressure of the eyeball is normalized with 10-0 nylon interrupted sutures between the skirt and the lamellar pocket.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Tsai RJ, Tseng SC. Human allograft limbal transplantation for corneal surface reconstruction. Cornea. 1994;13(5):389–400.

    Article  CAS  PubMed  Google Scholar 

  2. Pellegrini G, Traverso CE, Franzi AT, Zingirian M, Cancedda R, De Luca M. Long-term restoration of damaged corneal surfaces with autologous cultivated corneal epithelium. Lancet. 1997;349(9057):990–3.

    Article  CAS  PubMed  Google Scholar 

  3. Koizumi N, Inatomi T, Suzuki T, Sotozono C, Kinoshita S. Cultivated corneal epithelial stem cell transplantation in ocular surface disorders. Ophthalmology. 2001;108(9):1569–74.

    Article  CAS  PubMed  Google Scholar 

  4. Cardona H. Keratoprosthesis; acrylic optical cylinder with supporting intralamellar plate. Am J Ophthalmol. 1962;54:284–94.

    Article  CAS  PubMed  Google Scholar 

  5. Strampelli B. Osteo-odontokeratoprosthesis. Ann Ottalmol Clin Ocul. 1963;89:1039–44.

    CAS  PubMed  Google Scholar 

  6. Heimke G, Polack FM. Ceramic keratoprosthesis. Ber Zusammenkunft Dtsch Ophthalmol Ges. 1978;75:28–35.

    PubMed  Google Scholar 

  7. Worst J. Twenty-three years of keratoprosthesis research: present state of art. Refract Corneal Surg. 1993;9:188–9.

    Google Scholar 

  8. Legeais JM, Renard G, Parel JM, Savoldelli M, Pouliquen Y. Keratoprosthesis with biocolonizable microporous fluorocarbon haptic. Preliminary results in a 24-patient study. Arch Ophthalmol. 1995;113(6):757–63.

    Article  CAS  PubMed  Google Scholar 

  9. Dohlman CH, Schneider HA, Doane MG. Prosthokeratoplasty. Am J Ophthalmol. 1974;77(5):694–70.

    Article  CAS  PubMed  Google Scholar 

  10. Dohlman CH, Doane MG. Some factors influencing outcome after keratoprosthesis surgery. Cornea. 1994;13(3):214–8.

    Article  CAS  PubMed  Google Scholar 

  11. Crawford GJ, Hicks CR, Lou X, Vijayasekaran S, Tan D, Mulholland B, et al. The Chirila Keratoprosthesis: phase I human clinical trial. Ophthalmology. 2002;109(5):883–9.

    Article  PubMed  Google Scholar 

  12. Barber JC. Keratoprosthesis: past and present. Int Ophthalmol Clin. 1988;28(2):103–9.

    Article  CAS  PubMed  Google Scholar 

  13. Rao GN, Blatt HL, Aquavella JV. Results of keratoprosthesis. Am J Ophthalmol. 1979;88(2):190–6.

    Article  CAS  PubMed  Google Scholar 

  14. Aquavella JV, Rao GN, Brown AC, Harris JK. Keratoprosthesis. Results, complications, and management. Ophthalmology. 1982;89(6):655–60.

    Article  CAS  PubMed  Google Scholar 

  15. Barnham JJ, Roper-Hall MJ. Keratoprosthesis: a long-term review. Br J Ophthalmol. 1983;67(7):468–74.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Barber JC, Feaster F, Priour D. The acceptance of a vitreous carbon alloplastic material, Proplast, in the rabbit eye. Invest Ophthalmol Vis Sci. 1980;19(2):182–91.

    CAS  PubMed  Google Scholar 

  17. Trinkaus-Randall V, Capecchi J, Newton A, Vadasz A, Leibowitz H, Franzblau C. Development of a biopolymeric keratoprosthetic material. Evaluation in vitro and in vivo. Invest Ophthalmol Vis Sci. 1988;29(3):393–400.

    CAS  PubMed  Google Scholar 

  18. Ham DI, Lee JH. A tectonic keratoprosthesis using expanded polytetrafluoroethylene as a supporting skirt in humans. Korean J Ophthalmol. 1991;5(2):83–7.

    CAS  PubMed  Google Scholar 

  19. Kim HC. The experimental Seoul-type keratoprosthesis. Korean J Ophthalmol. 1992;6(2):55–61.

    CAS  PubMed  Google Scholar 

  20. Lee JHHD, Lee JH, Kim HC, Yu YS. Experimental keratoprosthesis using expanded PTFE (Gore-Tex®) as a supporting skirt. J Korean Ophthalmol Soc. 1992;33:555–63.

    Google Scholar 

  21. Lee JH, Wee WR, Chung ES, Kim HY, Park SH, Kim YH. Development of a newly designed double-fixed Seoul-type keratoprosthesis. Arch Ophthalmol. 2000;118(12):1673–8.

    Article  CAS  PubMed  Google Scholar 

  22. Guo A, Rife LL, Rao NA, Smith RE. Anterior segment prosthesis development: evaluation of expanded polytetrafluoroethylene as a sclera-attached prosthetic material. Cornea. 1996;15(2):210–4.

    Article  CAS  PubMed  Google Scholar 

  23. Wee WRCE, Kim HY, Lee JH. The effect of surface modification on retention period of Seoul type keratoprosthesis. J Korean Ophthalmol Soc. 1999;40:3292–301.

    Google Scholar 

  24. Kim MK, Park IS, Park HD, Wee WR, Lee JH, Park KD, et al. Effect of poly (ethylene glycol) graft polymerization of poly (methyl methacrylate) on cell adhesion. In vitro and in vivo study. J Cataract Refract Surg. 2001;27(5):766–74.

    Article  CAS  PubMed  Google Scholar 

  25. Chung ESWW, Park SH, Lee JH. Histological changes of rabbit cornea implanted with Seoul type keratoprosthesis. J Korean Ophthalmol Soc. 2000;41:34–41.

    Google Scholar 

  26. Kim HYWW, Jung ES, Lee JH, Park SH. Clinical, physical stability and histological biocompatibility of experimental Seoul type keratoprosthesis. J Korean Ophthalmol Soc. 2000;41:550–61.

    Google Scholar 

  27. Kim MK, Lee JL, Wee WR, Lee JH. Comparative experiments for in vivo fibroplasia and biological stability of four porous polymers intended for use in the Seoul-type keratoprosthesis. Br J Ophthalmol. 2002;86(7):809–14.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  28. Lee SM, Kim MK, Shin MS, Wee WR. Matrix metalloproteinase-9 expression in the Seoul-type keratoprosthesis implanted corneas with concurrent cultivated autologous oral mucosal epithelial cell transplantation. Graefes Arch Clin Exp Ophthalmol. 2013;251(2):619–22.

    Google Scholar 

  29. Kim MK, Lee JL, Wee WR, Lee JH. Seoul-type keratoprosthesis: preliminary results of the first 7 human cases. Arch Ophthalmol. 2002;120(6):761–6.

    Article  PubMed  Google Scholar 

  30. Kim MK, Lee SM, Lee JL, Chung TY, Kim YH, Wee WR, et al. Long-term outcome in ocular intractable surface disease with Seoul-type keratoprosthesis. Cornea. 2007;26(5):546–51.

    PubMed  Google Scholar 

  31. Lee SM, Kim MK, Oh JY, Heo JW, Shin MS, Lee MS, et al. Endoscopic vitrectomy improves outcomes of Seoul-type keratoprosthesis exchange in rabbit model. Invest Ophthalmol Vis Sci. 2008;49(10):4407–11.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Seoul National University College of Medicine and Seoul National University Hospital, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, South Korea

    Mee Kum Kim MD, PhD, Won Ryang Wee MD, PhD & Jin Hak Lee MD, PhD

  2. Laboratory of Corneal Regenerative Medicine and Ocular Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, South Korea

    Mee Kum Kim MD, PhD, Won Ryang Wee MD, PhD & Jin Hak Lee MD, PhD

Authors
  1. Mee Kum Kim MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Won Ryang Wee MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jin Hak Lee MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mee Kum Kim MD, PhD .

Editor information

Editors and Affiliations

  1. Cornea, External Disease and Refractive Surgery, Department of Ophthalmology and Visual Sciences, University of Illinois Eye and Ear Infirmary, Chicago, Illinois, USA

    M. Soledad Cortina

  2. Cornea, External Disease and Refractive Surgery, Department of Ophthalmology and Visual Sciences, University of Illinois Eye and Ear Infirmary, Chicago, Illinois, USA

    Jose de la Cruz

1 Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Seoul keratoprosthesis implantation in a chemically injured patient (MP4 5485 kb)

Pars plana endoscopic vitrectomy in a rabbit eye with implanted Seoul keratoprosthesis (MP4 5715 kb)

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Kim, M.K., Wee, W.R., Lee, J.H. (2015). Korea Seoul-Type KPro: Indications, Contraindications, and Surgical Techniques. In: Cortina, M., de la Cruz, J. (eds) Keratoprostheses and Artificial Corneas. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55179-6_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-55179-6_22

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-55178-9

  • Online ISBN: 978-3-642-55179-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation