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Review
. 2018 May;66(5):620-629.
doi: 10.4103/ijo.IJO_22_18.

Keratoprosthesis: Current global scenario and a broad Indian perspective

Geetha Iyer  1 , Bhaskar Srinivasan  1 , Shweta Agarwal  1 , Deepti Talele  1 , Ekta Rishi  2 , Pukhraj Rishi  2 , Sripriya Krishnamurthy  3 , Lingam Vijaya  3 , Nirmala Subramanian  4 , Shanmugasundaram Somasundaram  5
Affiliations
Review

Keratoprosthesis: Current global scenario and a broad Indian perspective

Geetha Iyer et al. Indian J Ophthalmol. 2018 May.

Abstract

Keratoprosthesis (Kpro) forms the last resort for bilateral end-stage corneal blindness. The Boston Type 1 and 2 Kpros, the modified osteo-odonto Kpro and the osteo-Kpro are the more frequently and commonly performed Kpros, and this review attempts to compile the current data available on these Kpros worldwide from large single-center studies and compare the indications and outcomes with Kpros in the Indian scenario. Although the indications have significantly expanded over the years and the complications have reduced with modifications in design and postoperative regimen, these are procedures that require an exclusive setup, and a commitment toward long-term follow-up and post-Kpro care. The last decade has seen a surge in the number of Kpro procedures performed worldwide as well as in India. There is a growing need in our country among ophthalmologists to be aware of the indications for Kpro to facilitate appropriate referral as well as of the procedure to enable basic evaluation during follow-ups in case the need arises, and among corneal specialists interested to pursue the field of Kpros in understanding the nuances of these surgeries and to make a judicious decision regarding patient and Kpro selection and more importantly deferral.

Keywords: Boston keratoprosthesis; keratoprosthesis; ocular surface disorders; osteoodonto keratoprosthesis.

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Conflict of interest statement

There are no conflicts of interest

Figures

Figure 1
Figure 1
Final appearance of the eye following Boston Type 1 keratoprosthesis (a), modified osteo-odonto keratoprosthesis (b) and Boston Type 2 keratoprosthesis (c) at postoperative 9, 12, and 2 years, respectively
Figure 2
Figure 2
(a) Retroprosthetic membrane in a silicone oil-filled eye after Boston Type 1 keratoprosthesis, not visually significant. (b) Carrier graft infiltration in an eye with vitreous exudates and endophthalmitis 2 years following Boston Type 1 keratoprosthesis. (c) Epithelial defect noted on fluorescein staining after BCL removal, not associated with thinning. (d) Sterile carrier graft melt with edge lift of the keratoprosthesis. (e) Perioptic annular melt with no leak. Note the air bubble in the gap beneath the flange of the optic. (f) Same eye as e following an annular lamellar graft
Figure 3
Figure 3
(a) Aqueous leak (indicated by yellow arrow) around the optical cylinder 8 years after modified osteo-odonto keratoprosthesis. (b) Laminar resorption seen following removal of the lamina
See this image and copyright information in PMC

Comment in

  • The journey of keratoprosthesis in India.
    Maskati QB. Maskati QB. Indian J Ophthalmol. 2018 May;66(5):615-616. doi: 10.4103/ijo.IJO_560_18. Indian J Ophthalmol. 2018. PMID: 29676299 Free PMC article. No abstract available.

References

    1. Khan B, Dudenhoefer EJ, Dohlman CH. Keratoprosthesis: An update. Curr Opin Ophthalmol. 2001;12:282–7. - PubMed
    1. Saeed HN, Shanbhag S, Chodosh J. The Boston keratoprosthesis. Curr Opin Ophthalmol. 2017;28:390–6. - PubMed
    1. Yaghouti F, Nouri M, Abad JC, Power WJ, Doane MG, Dohlman CH, et al. Keratoprosthesis: Preoperative prognostic categories. Cornea. 2001;20:19–23. - PubMed
    1. Dohlman CH, Mona HD, Graney J. The Boston keratoprosthesis: A new threadless design. Digit J Ophthalmol. 2007;13:3.
    1. Hille K, Grabner G, Liu C, Colliardo P, Falcinelli G, Taloni M, et al. Standards for modified osteoodontokeratoprosthesis (OOKP) surgery according to strampelli and falcinelli: The Rome-Vienna protocol. Cornea. 2005;24:895–908. - PubMed