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Legeais BioKpro III keratoprosthesis implantation: long term results in seven patients
  1. E J Hollick1,
  2. S L Watson2,
  3. J K G Dart2,
  4. P J Luthert2,3,
  5. B D S Allan2
  1. 1King’s College Hospital, Denmark Hill, London SE5 9RS, UK
  2. 2Moorfields Eye Hospital, City Road, London EC1V 2PD, UK
  3. 3Institute of Ophthalmology, University College London, 11–43 Bath Street, London EC1V 9EL, UK
  1. Correspondence to: Emma J Hollick Department of Ophthalmology, King’s College Hospital, Denmark Hill, London SE5 9RS, UK; emma.hollick{at}kingsch.nhs.uk

Abstract

Aims: The long term results of the Legeais BioKpro III keratoprosthesis are presented for seven patients with severe corneal scarring.

Methods: The study took place at Moorfields Eye Hospital, London. Patients had either end stage ocular surface disease or corneal opacification after multiple failed graft surgery, with the potential for significant visual improvement. After insertion the device was covered with a conjunctival flap or buccal mucous membrane graft, which was later opened to expose the optic. The outcome measures were vision, complications, and retention of the device.

Results: The BioKpro III was inserted into seven patients with severe corneal scarring: ocular cicatricial pemphigoid, measles keratitis, thermal injury, Stevens-Johnson syndrome, aniridia, chemical injury, and congenital rubella. The follow up was 18–48 months. The keratoprosthesis failed in six, because of extrusion occurring 2–28 months postoperatively. Retroprosthetic membranes occurred in three patients, and endophthalmitis in one. Vision improved from hand movements to 6/12 in the only patient who retained the KPro; however he was troubled by mucus accumulation on the optic.

Conclusions: The one success has been in a patient with thermal burns. The remaining results have been poor, with the KPro extruding in six of the seven patients.

  • BMG, buccal mucosal graft
  • ePTFE, expanded poly(tetrafluoroethylene)
  • HM, hand movement
  • IOP, intraocular pressure
  • KPro, keratoprosthesis
  • OCP, ocular cicatricial pemphigoid
  • OOKP, osteo-odontokeratoprosthesis
  • PDMS, poly(dimethylsiloxane)
  • PHEMA, poly(2-hydroxyethyl methacrylate)
  • PL, perception of light
  • PMMA, poly(methylmethacrylate
  • PTFE, poly(tetrafluoroethylene)
  • PVP, poly(vinylpyrollidone)
  • RPM, retroprosthetic membranes
  • SJS, Stevens-Johnson syndrome
  • keratoprosthesis
  • corneal blindness
  • BMG, buccal mucosal graft
  • ePTFE, expanded poly(tetrafluoroethylene)
  • HM, hand movement
  • IOP, intraocular pressure
  • KPro, keratoprosthesis
  • OCP, ocular cicatricial pemphigoid
  • OOKP, osteo-odontokeratoprosthesis
  • PDMS, poly(dimethylsiloxane)
  • PHEMA, poly(2-hydroxyethyl methacrylate)
  • PL, perception of light
  • PMMA, poly(methylmethacrylate
  • PTFE, poly(tetrafluoroethylene)
  • PVP, poly(vinylpyrollidone)
  • RPM, retroprosthetic membranes
  • SJS, Stevens-Johnson syndrome
  • keratoprosthesis
  • corneal blindness

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Footnotes

  • SLW is supported by a Health Professional Research Fellowship from the National Health and Research Council, Australia

  • Financial/proprietary interest: The authors have no commercial or proprietary interest in the Legeais BioKpro device. Likewise, they have no financial interest and do not receive payment as consultant, reviewer, or evaluator.

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