MAINTAINING A WATERTIGHT GLOBE WHILE OPERATING WITH A TEMPORARY KERATOPROSTHESIS

Abstract

To demonstrate that the Landers wide-field temporary keratoprosthesis (TKP) creates a watertight seal between the tightly opposing surfaces of the TKP flange and the anterior corneal surface. In 25 and 20 enucleated, porcine eyes, a 7.5-mm and 8.0-mm trephination corneal hole was made, respectively, followed by open-sky capsulorhexis and lensectomy. A wide-field TKP with 7.2 mm trunk diameter was sutured securely onto each eye. Testing for a watertight seal was performed at an intraocular pressure of 100 mmHg of pre- and post-pars plana vitrectomy. The Landers TKP maintained a watertight seal at an intraocular pressure of 100 mmHg in 45 of 45 eyes. After standard pars plana vitrectomy, 41 of 41 eyes maintained 100 mmHg of intraocular pressure without leakage. The seal between the TKP and cornea is established at the horizontal interface between the TKP flange and the anterior corneal surface, not between the corneal stroma and TKP trunk. The Landers wide-field TKP is a reusable model that provides a clear posterior-segment view and effectively forms a watertight eye at a sustained intraocular pressure of 100 mmHg. This TKP may be used in ocular trauma where the corneal defect is up to 0.8 mm greater in diameter than the 7.2-mm TKP trunk.