Purchase this article with an account.
Julio C Hernandez, Alejandro Navas, Juan Carlos Serna- Ojeda, Arturo J Ramirez-Miranda, Enrique O Graue; Boston type I Keratoprosthesis assisted with intra-prosthetic amniotic membrane (AmniotiKPro sandwich technique). Invest. Ophthalmol. Vis. Sci. 2014;55(13):3146.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To describe a novel technique of Boston type 1 keratoprosthesis (KPro) implantation assisted with intra-prosthetic amniotic membrane in patients with severe ocular surface inflammation
Two eyes of two patients with severe ocular surface inflammation and corneal blindness underwent KPro implantation assisted with intra-prosthetic amniotic membrane. This technique uses a cryopreserved amniotic membrane disc positioned directly beneath the front plate, with the donor cornea placed after creating a “sandwich” between the front plate, the amniotic membrane disc and the donor cornea
After a 3 month follow-up, both patients postoperatively maintained the KPro in place and the amniotic membrane well attached, with improvement in the uncorrected visual acuity and with anterior segment optical coherence tomography showing the intra-prosthetic amniotic membrane attached and filling the virtual space between the donor cornea and the anterior plate of the KPro. No episodes of melting, epithelial defects or infection were seen.
This technique provides an epithelization scaffold and an anti-inflammatory and antimicrobial platform in patients known to have underlying severe inflammatory ocular surface disease and altered ocular immunity, achieving good postoperative outcomes. A decreased incidence of tissue melting and KPro extrusion could be a possible benefit with this technique, at the same time the antimicrobial properties of the amniotic membrane and the mechanical closing of the gap between the optical stem and donor cornea are thought to decrease the rate of the keratitis and endophthalmitis associated to the KPro.
This PDF is available to Subscribers Only