Keratoprosthesis for the treatment of severe bilateral cornea disease

Alberta Heritage Foundation for Medical Research
Record ID 32001000940
Authors' objectives:

This report summarises the available literature on keratoprosthesis (KPro), an artificial cornea, as a treatment for adult patients with severe cornea disease.

Authors' recomendations: The rational for using KPro is that patients reciving corneal transplantation show variable success rates and a minority of conditions where corneal transplantation will certainly fail requires an alternative strategy. KPro may offer the only hope of usable vision for patients diagnosed with ocular cicatrial pemphigoid, Stevens-Johnson syndrome, end-stage dry eyes, severe chemical burns and those with repeated failure of corneal transplantation. Whenever a standard corneal transplantation has a reasonable chance of success, a KPro is clearly not indicated. No controlled clinical trials have been conducted for KPro because this procedure is the last option for the restoration of some visual function for a very small, specific group of patients. Limited data in the literature have shown that KPro surgery using different devices could, if performed carefully, restore some level of vision for a short or long period of time for patients, depending upon their preoperative diagnosis. The major problem with this procedure is that serious postoperative complications are very common. There is insufficient evidence to prove the safety and efficacy of any KPro model, and as KPro models keep evolving, these new versions have not yet been proven in clinical trials with sufficient follow-up and patient numbers. The procedure has only been performed in a few eye centres around the world using different KPro models. Currently there is no consensus in the literature on optimal device and implantation technique, and no accepted standard for this procedure. In general, KPro surgery is complicated, has a narrow safety margin, and requires intensive follow-up, thus a conservative approach is currently recommended by the eye specialists in the area.
Authors' methods: Overview
Project Status: Completed
Year Published: 2001
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Prostheses and Implants
  • Prosthesis Implantation
  • Cornea
  • Corneal Diseases
Organisation Name: Institute of Health Economics
Contact Address: 1200, 10405 Jasper Avenue, Edmonton, Alberta, Canada, T5J 3N4. Tel: +1 780 448 4881; Fax: +1 780 448 0018;
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Alberta Heritage Foundation for Medical Research (AHFMR)

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