Keratoprosthesis. Personal experience

Abstract

AbstractPurpose Comment the Barcelona experience with different types of keratoprosthesesMethods Six cases of different keratoprostheses implanted at the Barraquer Eye Center in Barcelona from 1955 to 2014 are discussed.Results The first keratoprosthesis implanted in Spain was a Dorzee acrylic keratoprosthesis in a case of bilateral chemical burn in 1955 with good functional and anatomic result for five years, when extrusion ocurred with simultaneous superior retinal detachment. The second case refers implantation of a Dorzee‐Barraquer‐Cardona acrylic keratoprosthesis in 1958 in a patient with terminal glaucoma. There was good anatomical retention until the patient’s death in 1970. In the third case a Cardona keratoprosthesis was implanted in 1960 after severe failure of two corneal transplants. Acute endophthalmitis ocurred after a satisfactory anatomical and functional result for 8 years. The fourth case shows extrusion of a Teflon‐supported keratoprosthesis (Girard). The fifth case discusses implantation of an osteo‐odonto‐keratoprosthesis (Strampelli)after blast injury with good anatomical and functional result for 10 years. The last case refers to the experience with the Boston keratoprosthesis in our Center since 2006.Conclusion Clinical experience for more than 50 years at the Barraquer Eye Center confirms evolution of the original Dorzee‐Keratoprosthesis to the nowadays widely used Boston keratoprosthesis. In spite of progress in surgical technique, design and postoperative treatment, anatomical and functional results continue being a challenge for KPro surgeons due to the relatively high frequency of unresolvable serious sight‐destructive complications.