title: Deposits in artificial corneas: risk factors and prevention.
abstract: OBJECTIVE
  To identify risk factors for calcium deposition and pigmented staining within AlphaCor artificial corneas.
  
  
  METHODS
  Retrospective analysis of data from 72 AlphaCor implantations was conducted. Histological analysis of explants was performed.
  
  
  RESULTS
  Eight cases of either intraoptic calcium or pigment deposition occurred in AlphaCor patients between 2.5 and 21 months after implantation. Four cases had diffuse white deposits, confirmed to be calcium and associated with prior coadministration of topical steroids and beta-blockers. The other four cases had brown deposits, associated with cigarette smoking and topical levobunolol.
  
  
  CONCLUSIONS
  These findings led to changes in patient management protocols, surgeon training and patient information so as to minimize the risk of further occurrences. No further cases of white deposition have occurred after warning surgeons of the risk associated with certain topical therapy combinations. The risk of brown staining may be difficult to remove completely as it appears that environmental exposure to chemicals may cause deposition in addition to personal smoking habits and topical medications.
authors.affiliation: Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia. crhicks@cyllene.uwa.edu.au
authors.forename: Celia R
authors.initials: CR
authors.lastname: Hicks
authors.forename: Traian V
authors.initials: TV
authors.lastname: Chirila
authors.forename: Liliana
authors.initials: L
authors.lastname: Werner
authors.forename: Geoffrey J
authors.initials: GJ
authors.lastname: Crawford
authors.forename: David J
authors.initials: DJ
authors.lastname: Apple
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Constable
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D001187:Artificial Organs; D001672:Biocompatible Materials; D002114:Calcinosis / Q000209:etiology* / Q000378:metabolism / Q000517:prevention & control*; D002118:Calcium / Q000378:metabolism; D003315:Cornea; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D002040:Levobunolol / Q000008:administration & dosage; D010859:Pigmentation Disorders / Q000209:etiology* / Q000378:metabolism / Q000517:prevention & control*; D019904:Polymethyl Methacrylate; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
chemical_list: D000319:Adrenergic beta-Antagonists; D001672:Biocompatible Materials; D005938:Glucocorticoids; D019904:Polymethyl Methacrylate; D002040:Levobunolol; D002118:Calcium