[Limits and possibilities of optical keratoprosthesis. A clinical and histopathological report (author's transl)]

Abstract

The author reports on the experience with 75 cases of optical keratoprosthesis performed since 1967. The keratoprosthesis were carried out either by intracorneal anchoring or according to Strampelli as osteo-odonto-keratoprosthesis. Short-term improvement (up to one year) was achieved in 25% of the cases, there was a improvement (up to 14 years) in eight patients. The operation had to repeated in 30%. The keratoprosthesis is anchored under a firmly attached flap of oral mucosa transplanted to the cornea after cataract operation. Common complications are glaucoma, hypotony syndrome, extrusion of the implant, development of a retroprosthetic membrane and retinal detachment. Only in cases of severe damage to the cornea after alkali or acid burns, trauma, or pemphigoid and failure of previous keratoplasties is a keratoprosthesis indicated. The degree of improvement usually depends on the pre-existing damage to the eye. The possibilities of keratoprosthesis are limited and functional improvement is frequently only of short duration. Intensive counseling and patient care are essential pre-requisites.