Keratoprosthesis. Results, complications, and management.

Thirty-one cases of keratoprosthesis were followed for periods of from 1 to 84 months (average 35 months). The Cardona through-and-through device was implanted, covered with periosteum, and exteriorized through an opening in the upper lid. Visual results varied from 20/20 (1 of 31 cases) to counting fingers (5 of 31 cases). While 12 of the 31 cases achieved 20/40 or better at some point in the postoperative course, only 5 of 31 maintained this level of acuity over a long-term period. Severe complications included retroprosthetic membrane (18 out of 31), vitreitis (7 out of 31), dislocation (5 out of 31), extrusion (3 out of 31), and endophthalmitis (5 out of 31). Fifteen of the 31 patients required subsequent surgical revision. Despite the frequency and severity of complications, 17 out of 31 patients achieved sufficient improvement in visual acuity to enable them to function without assistance for periods of 1 to 7 years.