Posters

Coralline hydroxyapatite keratoprosthesis: technique, description, and long-term visual outcomes

Poster Details

First Author: R.Barrera COLOMBIA

Co Author(s):    J. Barraquer Granados                    

Abstract Details

Purpose:

To report the surgical technique and the long-term visual outcomes and complications after Hydroxyapatite Keratoprosthesis (HaKPro) implant.

Setting:

Barraquer Clinic, Bogotá, Colombia.

Methods:

The records of all patients who were implanted with HaKPro between January 1996 and December 2017 at two ophthalmology centers were retrospectively analyzed. The coral, Porites Porites, was obtained from the Caribbean Coast of Colombia. Its carbon skeleton was transformed into hydroxyapatite by an endothermic reaction and molded to support a polymethyl methacrylate optical cylinder. After complete iridectomy, lens extraction and anterior vitrectomy, the prosthesis was fixed to the cornea through a scleral patch, three rectus muscle flaps and coating with oral mucosa.

Results:

Seven HaKPro procedures were performed in 7 eyes of six patients who suffered from chemical burn (4 eyes), cicatricial pemphigoid (1 eye) and Stevens-Johnson syndrome (2 eyes). 4 cases were excluded because the follow-up was less than two months. The mean follow-up duration was 15.4 years. Preoperative best corrected visual acuity (BCVA) was counting fingers in one eye and light perception in the other two. Postoperative BCVA at six months, five years and at final follow-up improved to 20/50, 20/80 and, 20/160 or better on each case, respectively. Most common postoperative complications included retroprosthetic membrane formation and incomplete haptic vascularization.

Conclusions:

The properties of biocompatibility, non-biodegradable and colonizable haptic of the HaKPro are associated with satisfactory functional and anatomic long-term outcomes. Moreover, the implant procedure can be done in one surgical time and does not require a donor. These characteristics make the HaKPro a cost-effective option to treat corneal blindness, however, prospective and randomized trials with bigger samples need to be done to recommend its therapeutic use.

Financial Disclosure:

None