Keratoprosthesis is a procedure used to treat Ocular Surface Disease.
The Boston Keratoprosthesis is an “artificial cornea” that can be used in patients with severe corneal opacity. It is most often used after a standard corneal transplant has failed or when a standard transplant using donated tissue would be unlikely to succeed.
The Procedure – In Detail
Prior to surgery, a detailed history will be taken which helps to assess the corneal condition and determine if the patient is a good candidate for the surgery.
The device is inserted into a corneal graft, which is then sutured into the patient’s cornea as in standard transplantation. If the natural lens is in place, it is also removed. Finally, a soft contact lens is applied to the surface; it must be worn around the clock, everyday. This does not cause any discomfort.
Our one-step surgery is simpler and faster than procedures used in other keratoprosthesis models; it generally requires about one and one half hours to complete. While general anesthesia is recommended, the recent trend is for performing the surgery under local anesthesia with intravenous sedation. Visual improvement is usually seen the following day or week(s). Although the prosthesis is clear, use of a colored contact lens can perfectly match the iris color of the opposite eye.
Because of possible complications that can result after many surgical procedures, patients with keratoprosthesis require relatively frequent ophthalmologic examination in the beginning. The patient should be seen the day following surgery, as well as during the first and second weeks after surgery. It is customary to return bimonthly for a check-up during the first year. After this time, examination by the surgeon every three to four months is also recommended.
For long-term postoperative safety it is recommended that the patient continuously wear the soft contact lens (not felt by patient) and use prophylactic antibiotic drops once or twice daily. Thus, a life-long regimen of daily drops of antibiotics is prescribed to prevent infection. In addition, medications to control inflammation and/or glaucoma are used when necessary.
Stability and Safety
The Boston Keratoprosthesis is known for excellent long-term (many years) stability and safety. Its optical system can provide normal vision if the rest of the eye is undamaged.
The surgery is performed on an outpatient basis so that the patient is able to leave the office immediately following surgery.
Notice: Video of real eye surgery. This video shows Thomas Harvey MD performing a Keratoprothesis surgery on a patient with an ocular surface disease. A device is implanted near the cornea. This is an outpatient surgery and has great success for improving vision.