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P. N. Youssef, J. S. Brown, M. Wu, T. T. Shen; Clinical Outcomes of Keratoprosthesis Implantation in Patients With Severe Corneal Blindness. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1893.
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To evaluate clinical outcomes of implantation of the Dohlman type keratoprosthesis (K-Pro) in the treatment of severe corneal blindness.
A case series was conducted to review the clinical indications, surgical complications, and outcomes in a cohort of patients receiving the Dohlman type K-Pro for the treatment of severe corneal blindness. Since June of 2004 thirteen patients have received an artificial cornea in a total of fifteen eyes at the University of Washington.Background: Corneal blindness is the second most common treatable form of blindness world-wide, afflicting more than six million people. Corneal transplantation using high quality human donor corneas frequently provides successful treatment; however, many cases of severe corneal blindness are not amenable to routine corneal transplant using human donor tissue alone. An artificial corneal implant or keratoprosthesis (K-Pro) is considered the treatment of choice for patients with severe corneal blindness where corneal transplantation with human donor tissue has been attempted and failed or will likely fail.
Indication for surgery in this cohort included trauma (chemical burn, ruptured globe), pseudophakic bullous keratopathy, aniridia, and repeated graft failure. Vision in the affected eye prior to surgery ranged from 20/200 to light perception. Postoperatively, patients attained visual acuities ranging from 20/20 to hand motion at 2 feet. Nine out of fifteen operated eyes attained a visual acuity better than 20/200. Three out of fifteen eyes attained a visual acuity between 20/200 and 20/400. Three eyes exhibited a final postoperative visual acuity of worse than 20/400. Complications included wound leak (necessitating K-Pro revision), vitreous hemorrhage, glaucoma, and the development of vitreous cell not attributable to surgical recovery.
Limited experience with the Dohlman K-Pro at the University of Washington has demonstrated that this device can be used to restore functional vision to a cohort of patients with severe corneal blindness not ammenable to treatment with conventional corneal transplantation.
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