The Type II Aachen-Keratoprosthesis in humans: case report of the first prolonged application.
OBJECTIVE
To improve the prognosis of corneal grafts in silicone-oil filled eyes of patients with severe ocular trauma by a prolonged application of the Type II Aachen-Keratoprosthesis (KPro). This application endeavors to improve post-keratoplasty prognosis by avoiding corneal endothelial dystrophy in the aphakic eye due to contact with silicone oil. PATIENT AND PROCEDURES: The Aachen-Keratoprosthesis' haptic was modified to allow tight contact with cells. The Type II Aachen-Keratoprosthesis was then implanted in an 18-year-old male, with previous management of bilateral corneal rupture. Rather than utilize the device as a temporary intraoperative tool, we extended the device's lifespan in the eye.


RESULTS
Following implantation, the patient could see hand movements up to 0.1 with best correction. After 8 weeks, vision decreased and a retroprosthetic membrane proliferated. Upon conjunctival retraction, 3 months after the initial surgery, we excised the prosthesis and performed a re-vitrectomy and corneal grafting. The silicone oil was removed. After eighteen postoperative months, the graft remained clear, the retina was completely attached, and the vision was stable: 0.1 best corrected.


CONCLUSIONS
This case reports the prolonged implantation and prospect of the Type II Aachen-Keratoprosthesis to be utilized as a permanent device to restore vision in the near future.
Department of Ophthalmology, RWTH Aachen, Germany. sirpa_kompa@yahoo.de
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Kompa
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Redbrake
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Langefeld
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Brenman
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Schrage
D000293:Adolescent; D001187:Artificial Organs; D003315:Cornea / Q000601:surgery*; D065306:Corneal Injuries; D005107:Explosions; D006801:Humans; D008297:Male; D019736:Prostheses and Implants; D011474:Prosthesis Design; D012163:Retinal Detachment / Q000601:surgery; D012828:Silicones; D014792:Visual Acuity; D014821:Vitrectomy
D012828:Silicones