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LVP keratoprosthesis: anatomical and functional outcomes in bilateral end-stage corneal blindness
  1. Sayan Basu1,
  2. Ritu Nagpal1,
  3. Juan Carlos Serna-Ojeda1,
  4. Swapnil Bhalekar1,2,
  5. Bhupesh Bagga1,
  6. Virender Sangwan1
  1. 1 Tej Kohli Cornea Institute, LV Prasad Eye Institute, Hyderabad, India
  2. 2 Vision Care Center, Super-specialty Eye Hospital, Pune, India
  1. Correspondence to BasuSayanDr, Cornea and Anterior Segment Services, Tej Kohli Cornea Institute, LV Prasad Eye Institute, Kallam Anji Reddy Campus, Banjara Hills 500034, Hyderabad, India; sayanbasu{at}lvpei.org

Abstract

Purpose To describe the anatomical and functional outcomes of the novel LVP keratoprosthesis (Kpro), developed as an alternative to the modified osteo-odonto keratoprosthesis (MOOKP), in eyes with end-stage corneal blindness where conventional corneal surgeries are contraindicated.

Methods This prospective case series included 58 eyes of 56 patients (12 children and 44 adults) with severe bilateral keratopathy and completely dry, dermalised ocular surfaces who underwent unilateral LVP Kpro implantation from 2012 to 2016. In this two-stage procedure, an ocular surface labial mucous membrane grafting was performed, followed for 3 months by the implantation of the device under the engrafted mucosal flap. The primary outcome measures were anatomical retention rate and improvement in best corrected visual acuity (BCVA). The secondary outcome measure was rate of occurrence of complications.

Results Mean postoperative follow-up was 2.5±1.1 years. Kaplan-Meier survival analysis showed an anatomical retention rate of 90.8%±3.9% at 1 year, 80%±5.7% at 2 years and 76.6%±6.5% at 3–5 years. The survival rates were comparable in children and adults (91% vs 72% at 5 years, p=0.258). About 61.5% of eyes maintained 20/400 or better vision and median BCVA improved from perception of light to 20/70 at 1 year postoperatively (p<0.0001). Complications like retroprosthetic membrane formation, glaucoma, vitritis, endophthalmitis and panophthalmitis occurred in 43%, 26%, 22%, 12% and 3% of the eyes, respectively.

Conclusion The LVP Kpro is an effective procedure for the treatment of end-stage corneal blindness in completely dry eyes. The LVP Kpro can be particularly useful in situations where the MOOKP is contraindicated or difficult to perform.

  • cornea
  • ocular surface
  • treatment surgery

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Footnotes

  • SB, RN and JCS-O contributed equally.

  • Funding This work was funded by the Hyderabad Eye Research Foundation, Hyderabad, India and Champalimaud Foundation, Lisbon, Portugal. The sponsoring organisations had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Ethics approval Institutional Review Board (IRB) and the Ethics Committee, LV Prasad Eye Institute.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent Parental/guardian consent obtained.

  • Data sharing statement There is no additional unpublished data that are available anywhere else or with anyone else.

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