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Chapter-35 Update on Keratoprosthesis Surgery

BOOK TITLE: Surgical Techniques in Ophthalmology: Corneal Surgery

Author
1. Alio Jorge L
2. Arnalich Francisco
ISBN
9788184488579
DOI
10.5005/jp/books/11369_35
Edition
1/e
Publishing Year
2010
Pages
11
Author Affiliations
1. Avda de Denia s/n, Edificio Vissum, Alicante, Spain, Instituto Oftalmologico de Alicante, IOIS General Secretary, AVDA–DE, Denia, Alicante, Spain, Miguel Hernandez University, Medical School; Vissum Corporation, Alicante, Spain, Instituto Oftalmologico De Alicante, Avda Denia 111, 03016, Edificio Vissum, Alicante, Spain, VISSUM, Instituto Oftalmológico de Alicante, Avda de Denia S/n 03016, Alicante, Spain, Universidad Miguel Hernández, Alicante, Spain, Vissum Corporación Oftalmológica, Alicante, Spain, Vissum, Institute of Ophthalmology Alicante, Alicante, Spain, VISSUM Instituto Oftalmológico, Alicante, Spain; Universidad Miguel Hernández, Alicante, Spain, Department of Ophthalmology, Universidad Miguel Hernandez, Spain, University Miguel Hernandez de Elche, Alicante, Spain
2. Instituto Oftalmologico, De Alicante, Avda. Denia 111, 03015, Alicante, Spain, Institute of Ophthalmology of Alicante, Alicante, Spain, Vissum, Institute of Ophthalmology Alicante, Alicante, Spain, Moorfields Eye Hospital, NHS, Foundation Trust, London, Spain
Chapter keywords
cornea, corneal opacity, monocular blindness, Standard keratoprosthesis surgery, ophthalmologists, epithelialized artificial button, corneal host regeneration, Osteo-Odonto Keratoprosthesis, AlphaCor Keratoprosthesis

Abstract

The cornea is the most important refractive element of the human eye, providing approximately two-thirds of its optical power, about 43–44 diopters at the corneal apex. It fulfills the functions of refraction, protection, and transparency. Normal visual function in the human eye requires light to reach the retina through a transparent cornea; therefore, any pathological condition that reduces corneal transparency will lead to visual impairment or blindness. Corneal opacity is a common cause of monocular blindness, and follows cataracts as a leading cause of blindness worldwide. The current treatment for corneal induced blindness is grafting with human donor tissue. Standard keratoprosthesis surgery is infrequently performed by a few ophthalmologists. History of keratoprosthesis is explained. The ideal keratoprosthesis is defined as an epithelialized artificial button that could be implanted as in standard keratoplasty. Keratoprosthesis models range from purely synthetic devices, to models that allow for some corneal host regeneration and promote biointegration. Three models that are currently more used in clinical practice are Osteo-Odonto Keratoprosthesis, Boston Keratoprosthesis, and AlphaCor Keratoprosthesis are described. Besides this, other types of keratoprosthesis are also explained.

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