Keratoprostheses for corneal blindness: a review of contemporary devices

Abstract

Venkata S Avadhanam,1,2 Helen E Smith,2 Christopher Liu1–3 1Sussex Eye Hospital, 2Brighton and Sussex Medical School, Brighton, 3Tongdean Eye Clinic, Hove, UK Abstract: According to the World Health Organization, globally 4.9 million are blind due to corneal pathology. Corneal transplantation is successful and curative of the blindness for a majority of these cases. However, it is less successful in a number of diseases that produce corneal neovascularization, dry ocular surface and recurrent inflammation, or infections. A keratoprosthesis or KPro is the only alternative to restore vision when corneal graft is a doomed failure. Although a number of KPros have been proposed, only two devices, Boston type-1 KPro and osteo-odonto-KPro, have came to the fore. The former is totally synthetic and the latter is semi-biological in constitution. These two KPros have different surgical techniques and indications. Keratoprosthetic surgery is complex and should only be undertaken in specialized centers, where expertise, multidisciplinary teams, and resources are available. In this article, we briefly discuss some of the prominent historical KPros and contemporary devices. Keywords: keratoprosthesis, OOKP, KPro, Boston KPro, cornea, ocular surface