Abstract
Purpose
AlphaCor™ (Argus Biomedical Pty. Ltd., Perth, Australia) is an artificial, soft, one-piece keratoprosthesis (KPro) indicated for severe corneal conditions not treatable by a donor graft. To evaluate the efficacy and visual restoring of six patients with complete corneal opacification and deep neovascularizations treated with AlphaCor™.
Methods
A retrospective review of six patients with a history of corneal opacification treated with keratoprosthesis surgery. AlphaCor™ synthetic cornea was implanted into the corneal stroma. During the follow-up time, slit-lamp and ultrasound examinations, best corrected visual acuity (BCVA), and intraocular pressure measurements were performed.
Results
Six eyes with corneal scarring and vascularizations in three to four quadrants of six patients to years of age underwent a keratoprosthesis procedure. The follow-up time was 13–36 months; mean 23 months. The operation procedure was not limited by severe complications. The preoperative BCVA was hand movement to light perception. The postoperative BCVA ranged between 20/200 and 80/100. Intraocular pressure was controlled in all cases. Three patients developed a melting of the anterior corneal lamella. The keratoprosthesis had to be explanted (15–34 months after implantation) and was replaced by a donor cornea.
Conclusions
Further evaluation is needed to evaluate the role of AlphaCor™ as a keratoprosthesis.
Similar content being viewed by others
References
Bleckmann H, Holak S (2006) Preliminary results after implantation of four AlphaCor artificial corneas. Graefes Arch Clin Exp Ophthalmol 244(4):502–506. doi:10.1007/s00417-005-0068-6
Caporossi A, Mazzotta C, Balestrazzi A, Occhini R, Toti PT, Raversi C (2006) Histopathology of explanted AlphaCor due to keratoprosthesis extrusion. Clin Experiment Ophthalmol 34:457–459. doi:10.1111/j.1442-9071.2006.01249.x
Chalam KV, Chokshi A, Agarwal S, Edward DA (2007) Complications of AlphaCor keratoprosthesis. A clinicopathologic report. A clinicopathologic report. Cornea 26:1258–1260
Chirila TV, Constable IJ, Crawford GJ et al (1993) Poly (2-hydroxyethyl methacrylate) sponges as implant materials: in vivo and in vitro evaluation of cellular invasion. Biomaterials 23:26–38. doi:10.1016/0142-9612(93)90072-A
Crawford GJ, Eguchi H, Hicks CR (2005) Two cases of AlphaCor surgery performed using a small incision technique. Clin Experiment Ophthalmol 33:10–15. doi:10.1111/j.1442-9071.2005.00937.x
Eguchi H, Hicks CR, Crawford GJ et al (2004) Cataract surgery with AlphaCor artificial cornea. J Cataract Refract Surg 30:1486–1490. doi:10.1016/j.jcrs.2003.12.026
Griffith M, Hakim M, Shimmura S et al (2002) Artificial human corneas: scaffolds for transplantation and the regeneration. Cornea 21:54–61. doi:10.1097/01.ico.0000263120.68768.f8
Hicks CR, Chirila TV, Werner L, Crawford GJ, Apple DJ, Constable IJ (2004) Deposits in artificial corneas: risk factors and prevention. Clin Exp Ophthalmol 32:185–191. doi:10.1111/j.1442-9071.2004.00781.x
Hicks CR, Crawford GJ, Tan DT et al (2002) Outcomes of implantation of an artificial cornea, AlphaCor: effects of prior ocular herpes simplex infection. Cornea 21:685–690. doi:10.1097/00003226-200210000-00010
Hicks CR, Crawford GJ (2003) Melting after keratoprosthesis implantation: the effects of medroxyprogesterone. Cornea 22:497–500. doi:10.1097/00003226-200308000-00001
Hicks CR, Crawford G, Chirila T et al (2000) Development and clinical assessment of an artificial cornea. Prog Retin Eye Res 19:149–170. doi:10.1016/S1350-9462(99)00013-0
Hicks CR, Crawford GJ, Dart JKG, Grabner G, Holland EJ, Stulting RD, Tan DT, Bulsara M (2006) AlphaCor Clinical Outcomes. Cornea 25:1034–1042
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
Hicks CR, Hamilton S (2005) Retroprosthetic membranes in AlphaCor patients: risk factors and prevention. Cornea 24:692–698
Hicks CR, Werner L, Vijayasekaran S, Mamalis N, Apple DJ (2005) Histology of AlphaCor skirts. Evaluation of biointegration. Cornea 24:933–940
Lacombe E (2001) Role of hydromechanical fixation in haptic biocolonization. An Inst Barraquer (Barc) 30:103–107
Legeais JM, Drubaix I, Briat B, Renard G, Pouliquen Y (1997) 2nd generation bio-integrated keratoprosthesis. Implantation in animals. J Fr Ophthalmol 20:42–48
Morrison DA, Gridneva Z, Chirila TV, Hicks CR (2006) Screening for drug-induced spoliation of the hydrogel optic of the AlphaCorTM artificial cornea. Contact Lens & Anterior Eye 29:93–100
Vijayasekaran S, Fitton JH, Hicks CR et al (1998) Cell viability and inflammatory response in hydrogel sponges implanted in the rabbit cornea. Biomaterials 19:2255–2267
Zerbe BL, Belin MW, Ciolino JB (2006) Boston Type 1 Keratoprosthesis Study Group. Results from the multicenter Boston Type 1 Keratoprosthesis Study. Ophthalmology 113(10):1779.e1–7. Oct
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Holak, S.A., Holak, H.M. & Bleckmann, H. AlphaCor™ keratoprosthesis: postoperative development of six patients. Graefes Arch Clin Exp Ophthalmol 247, 535–539 (2009). https://doi.org/10.1007/s00417-008-0964-7
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-008-0964-7