Development of a newly designed double-fixed Seoul-type keratoprosthesis.
OBJECTIVE
To develop a newly designed double-fixed keratoprosthesis (Seoul-type keratoprosthesis [S-KPro]) and to assess its mechanical stability and biocompatibility.


METHODS
Twenty-five rabbits were divided into 4 groups by fixation technique, amniotic membrane (AM) implantation, and skirt material. The eyes were studied with the use of slitlamp, light, and electron microscopy. Stress testing was performed. In addition, 2 human subjects underwent S-KPro implantation. Best-corrected visual acuity was checked, and ophthalmic examination was performed.


RESULTS
The average retention period of the group receiving double-fixated polyurethane-S-KPro with AM was longer (>24 weeks) than that of the others. Fibroblast invasions were found in polyurethane pores but not in polytetrafluoroethylene (Gore-Tex) pores on light microscopy. The minimal pressure that induced aqueous leakage was greater than 250 mm Hg in all of the tested eyes. Two human subjects have maintained a good postoperative condition for 18 and 8 months.


CONCLUSIONS
The double-fixation technique of applied S-KPro and AM appears to be helpful in improving the stability of the keratoprosthesis. Polyurethane with relatively large pore size (40 microm) may be used successfully as a material for the keratoprosthesis skirt.


CONCLUSIONS
Our results may be important for improving the clinical outcome of keratoprosthesis.
Lee
J H
JH
Department of Ophthalmology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea. jjhlee@plaza.snu.ac.kr
Wee
W R
WR
Chung
E S
ES
Kim
H Y
HY
Park
S H
SH
Kim
Y H
YH
D000328:Adult; D000650:Amnion; D000818:Animals; D001672:Biocompatible Materials; D001696:Biomechanical Phenomena; D002057:Burns, Chemical / Q000601:surgery; D003094:Collagen / Q000378:metabolism; D003315:Cornea / Q000378:metabolism / Q000601:surgery*; D003316:Corneal Diseases / Q000378:metabolism / Q000601:surgery*; D065306:Corneal Injuries; D005126:Eye Burns / Q000139:chemically induced / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate; D011138:Polytetrafluoroethylene; D011140:Polyurethanes; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods*; D011817:Rabbits; D013262:Stevens-Johnson Syndrome / Q000601:surgery; D014792:Visual Acuity
D001672:Biocompatible Materials; D011140:Polyurethanes; D011138:Polytetrafluoroethylene; D003094:Collagen; D019904:Polymethyl Methacrylate