Abstract
Purpose :
Various carriers for the Boston Keratoprosthesis (KPro) have been proposed including xenografts, autografts, collagen constructs, as well as fresh, frozen, dehydrated and γ-irradiated allografts. One potential limiting factor in the use of these carriers is the discrepancy in thickness. We examine the impact of corneal thickness on aqueous leak after KPro implantation.
Methods :
Using a femtosecond laser, ethanol-preserved corneal donor buttons were mounted on an artificial anterior chamber and cut to various thicknesses. Anterior segment OCT was used to measure the thickness before and after the cut creation. A dermatologic punch was used to make a central hole and the KPro was assembled in the standard fashion. The assembled corneal construct was mounted onto the anterior chamber which was attached to a phacoemulsification machine with the intraocular pressure (IOP) set at the lowest setting of 20 mmHg. The IOP was gradually increased and a fluorescein strip was used to check Seidel positivity.
Results :
Three corneas were cut with resulting post-cut thicknesses of 168 µm, 346 µm, and 413 µm, and a fourth cornea was left uncut with a thickness of 858 µm. When connected to the phacoemulsification machine, the three cut corneas were Seidel positive at 20 mmHg, while the fourth remained Seidel negative even at maximal IOP (80 mmHg).
Conclusions :
A minimal corneal carrier graft thicknesses between 413 µm and 858 µm is required to avoid intraoperative leak during KPro implantation. Additional experiments are needed to further narrow down this range.
This is a 2021 ARVO Annual Meeting abstract.