A new epidescemetic intrastromal keratoprosthesis

Session Details

Session Title: Cornea Surgical II

Session Date/Time: Tuesday 16/09/2014 | 08:00-10:30

Paper Time: 08:50

Venue: Boulevard B

First Author: : A.Abdelghany SPAIN

Co Author(s): :    J. Alio   A. Vega-Estrada   R. Fernandez-Buenaga        

Abstract Details

Purpose:

To report the outcomes of the new keratoprosthesis KeraKlear performed in 10 eyes.

Setting:

Vissum Corporación Alicante, Universidad Miguel Hernández, Alicante, Spain.

Methods:

This pilot study was in 10 consecutive eyes, 3 eyes with corneal decompensation, 3 eyes with total corneal leucoma, 1 eye with failed previous penetrating keratoplasty, 1 eye with failed previous keratoprosthesis, and 2 eyes with total leucoma from chemical burn. Study design was prospective interventional series of cases. Keratoprosthesis implantation was performed in 7 eyes and combined penetrating keratoplasty and keratoprosthesis implantation in the other 3 eyes. The procedure for keratoprosthesis was the same either in the cornea of the patient in the 7 eyes or the implanted cornea in the other 3 eyes. The surgical procedure was performed assisted by femtosecond (FS) laser (IntraLase. AMO). First, 8 mm corneal diameter dissection was done at 470 μm of depth. The laser energy settings were 3 μJ with a raster method with spot separation and line separation at 4 μm. A second corneal dissection of 3.5 mm at 320 μm of depth with the same energy settings was performed. The central 3.5 mm disc of the anterior cornea was removed. The KeraKlear (KeraMed Inc. California, U.S.A.) was held by insertion forceps and inserted into the cornea and then sutured to the cornea. Contact lens was applied for protection.

Results:

In 6 eyes the device was centered in the pupillary area with no infection or inflammation. Anterior segment optical coherence tomography (OCT) showed a good position of the keratoprosthesis. The rim of the device was inside the pocket. No sign of extrusion was detected. Vision improved in 4 eyes and remains unchanged in 2 eyes. 1 eye developed retroprosthetic inflammatory membrane and required penetrating keratoplasty, 1 eye developed retroprosthetic inflammatory membrane and required penetrating keratoplasty and keratoprosthesis implantation, 1 eye developed corneal melting and required penetrating keratoplasty and 1 eye developed corneal melting and retroprosthetic inflammatory membrane ended by extrusion of the keratoprosthesis and total leucoma.

Conclusions:

In this pilot study, the new epidescemetic intrastromal keratoprosthesis (KeraKlear) is shown to be a viable alternative to corneal transplantation with potential advantages over the previous total corneal keratoprosthesis models.

Financial Interest:

NONE