H Bleckmann1, S Holak. 1. Eye Department of DRK Kliniken Westend, Spandauer Damm 130, 14050, Berlin, Germany. Prof.Dr.H.Bleckmann@t-online.de
Abstract
PURPOSE: The purpose was to evaluate the validity of implantation of the artificial cornea (AlphaCor) in human corneas considered too high risk for penetrating keratoplasty with donor tissue. METHODS: Four keratoprostheses, made from poly(2-hydroxyethyl methacrylate) (PHEMA) with a porous skirt and a transparent optical part, were implanted into the cornea of four patients. Keratocytes invading the skirt provide a watertight fixation with the scarred corneal tissue. Deep to the clear optical part, the posterior corneal lamella was excised to a diameter of 3.5 mm before the device was implanted, and the anterior lamella was trephined similarly 3 months after AlphaCor implantation. RESULTS: The eyes selected to receive an artificial cornea had significant neovascularisation, and 0-3 previous failed grafts. Follow-up for 6 months revealed best visual acuity between 20/400 and 20/50. Factors limiting the visual acuity outcome were optic atrophy and age-related macular disease. One patient underwent an extracapsular cataract extraction after the device was implanted, as a senile cataract was then noted. One complication occurred, a central corneal stromal melt, which was managed by covering with a 9-mm donor lamella. CONCLUSION: The flexible device AlphaCor may provide a substitute for donor corneal tissue in desperate cases. Advantages include the simple implantation technique, which avoids trauma to the surrounding structures. Visual acuity results may be limited by pre-existing pathology, but it appears that a patient's visual potential can be achieved. Further follow-up to exclude long-term complications is required.
PURPOSE: The purpose was to evaluate the validity of implantation of the artificial cornea (AlphaCor) in human corneas considered too high risk for penetrating keratoplasty with donor tissue. METHODS: Four keratoprostheses, made from poly(2-hydroxyethyl methacrylate) (PHEMA) with a porous skirt and a transparent optical part, were implanted into the cornea of four patients. Keratocytes invading the skirt provide a watertight fixation with the scarred corneal tissue. Deep to the clear optical part, the posterior corneal lamella was excised to a diameter of 3.5 mm before the device was implanted, and the anterior lamella was trephined similarly 3 months after AlphaCor implantation. RESULTS: The eyes selected to receive an artificial cornea had significant neovascularisation, and 0-3 previous failed grafts. Follow-up for 6 months revealed best visual acuity between 20/400 and 20/50. Factors limiting the visual acuity outcome were optic atrophy and age-related macular disease. One patient underwent an extracapsular cataract extraction after the device was implanted, as a senile cataract was then noted. One complication occurred, a central corneal stromal melt, which was managed by covering with a 9-mm donor lamella. CONCLUSION: The flexible device AlphaCor may provide a substitute for donor corneal tissue in desperate cases. Advantages include the simple implantation technique, which avoids trauma to the surrounding structures. Visual acuity results may be limited by pre-existing pathology, but it appears that a patient's visual potential can be achieved. Further follow-up to exclude long-term complications is required.
Authors: C Hicks; G Crawford; T Chirila; S Wiffen; S Vijayasekaran; X Lou; J Fitton; M Maley; A Clayton; P Dalton; S Platten; B Ziegelaar; Y Hong; A Russo; I Constable Journal: Prog Retin Eye Res Date: 2000-03 Impact factor: 21.198
Authors: V Trinkaus-Randall; J Capecchi; A Newton; A Vadasz; H Leibowitz; C Franzblau Journal: Invest Ophthalmol Vis Sci Date: 1988-03 Impact factor: 4.799