Sessile macrophages forming clear endothelium-like membrane on inside of successful keratoprosthesis.

Clinical observation and cytological study of a reasonably successful keratoprosthesis removed along with a corneal button about 20 years after its implantation in an aphakic eye revealed an acellular epithelium-like film on its outer surface, firm anchoring of its supporting skirt by stable fibrous connections to the corneal stroma, and a continuous separating membrane composed of a homogeneous proteinaceous film and fibroblast-like cells of macrophage origin on its inner surface. The significance of the successful adaptation of the plastic materials of the prosthesis to the tissues of the cornea and the fluids of the inner eye for the future of tissue engineering in the region of the eye is discussed.