[Keratoprosthesis with biocolonizable support].

Abstract

Keratoprosthesis consists in replacing the central cornea with an optical system. The optic requires a support which was usually located in front of or behind the cornea. In our opinion microporous materials can hold the prosthesis in place and prevent melting and leakage. The prosthesis is implanted in a single procedure. The optical core is made of clinical quality PMMA. The core is 5 mm in diameter and 2.5 mm long. To promote tissue stability, 9 mm of a new microporous fluorocarbon (200 microns thick and 80 microns pore size) is used. The material becomes transparent and wettable after implantation in the human cornea as confirmed by experimental investigation. The material of the flange is initially hydrophobic and maintains the depth of the anterior chamber without leakage. We present our results concerning the 10 consecutive cases. The average follow-up is 11 months (range; 6 to 17 months). The surgical indication was 4 cases of corneal burns, 3 cases of pseudopemphigus, 1 trachoma, and 2 cases of corneal edema. Visual acuity was 20/60 (range: 20/400 to 20/30). Anatomic failures occurred in 2 cases in the first two months. We observed one traumatic dislocation of the optic system and one extrusion in the first week after error of manipulation of the polymer. The 5 mm optical diameter of the keratoprosthesis allows a visual field of about 120 degrees.