Abstract
Severe ocular diseases may result in partial or complete limbal cell deficiency. Besides conservative options, treatment options include conjunctival replacement procedures and limbal autografting. Limbal allografts are an option in patients with bilateral limbal cell deficiency. In many of these cases, a keratoprosthesis (KPro) is the last option to restore functional vision in patients with severe corneal blindness with no other options.
Highlights
Severe ocular diseases such as Stevens-Johnson syndrome (SJS), mucous membrane pemphigoid (MMP), or severe ocular burns may result in partial or complete limbal cell deficiency
SJS generally starts with an acute inflammation of the ocular surface followed by chronic conjunctivitis, whereas MMP usually has an insiduous beginning with slow progression of cicatrization leading to cicatricial lid complications with subsequent ocular surface damage and corneal scarring
Boston Keratoprosthesis Pioneered by Claes Dohlman, the Boston Kpro was initially made of PMMA with a collar button design consisting of three components: a solid front plate with an optical stem, a back plate with nutritional openings, and a small titanium locking ring
Summary
Severe ocular diseases such as Stevens-Johnson syndrome (SJS), mucous membrane pemphigoid (MMP), or severe ocular burns may result in partial or complete limbal cell deficiency. This in turn may lead to severe vision impairment or corneal blindness. Since about 25 years, amniotic membrane has been shown to be a good tool in ocular surface reconstruction—especially in the acute stage. Like topical and systemic medical therapy as well as contact lenses, chronic stage treatment options include conjunctival replacement procedures and limbal autografting.
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