Retroprosthetic membranes in AlphaCor patients: risk factors and prevention.
OBJECTIVE
To report retroprosthetic membrane (RPM) formation in association with AlphaCor and identify risk factors for their formation and strategies for prevention and management.


METHODS
Review of AlphaCor data and case histories and literature review.


RESULTS
RPMs occurred with AlphaCor in 14 (9.3%) cases. We find significant associations with systemic risk factors (race, hypertension, diabetes mellitus) rather than ocular history, but perioperative management may also be related to risk of RPM development. Histology demonstrates a fibrovascular tissue resembling scarred corneal tissue. Similar histologic findings have been reported for other devices.


CONCLUSIONS
Retrocorneal membranes and RPMs with earlier keratoprostheses have frequently been reported without specific identifiable causes. Diabetes is known to be associated with intraocular membrane formation. This study demonstrates that systemic factors affect the risk of RPM formation with AlphaCor. In cases identified as at greater risk of membrane formation, peri- and postoperative therapies such as steroids, non-steroidals, heparin or rTPA should be considered. In our series, several therapeutic and surgical strategies appear effective but recognizing patients at increased risk pre-operatively and using preventive measures where indicated is likely to be key to minimizing the incidence of this complication.
Hicks
Celia R
CR
Biomaterials Research Centre, Lions Eye Institute, University of Western Australia, Perth, Australia. crhicks@cyllene.uwa.edu.au
Hamilton
Stephen
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001187:Artificial Organs; D003315:Cornea; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D004358:Drug Therapy; D005260:Female; D006801:Humans; D008297:Male; D008566:Membranes / Q000473:pathology; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D011183:Postoperative Complications; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000009:adverse effects*; D012307:Risk Factors