Moscow eye microsurgery complex in Russia keratoprosthesis in Beijing.
OBJECTIVE
To evaluate the efficacy and preliminary safety of the Moscow Eye Microsurgery Complex in Russia (MICOF) keratoprosthesis in eyes with complicated corneal opacities unsuitable for keratoplasty.


METHODS
Retrospective review of consecutive clinical case series.


METHODS
We analyzed 85 eyes of 85 patients who previously underwent MICOF keratoprosthesis implantation at the Chinese PLA General Hospital between April 1, 2000, and August 31, 2009. The mean follow-up after MICOF keratoprosthesis implantation (measured after the second stage of the implantation) was 34.7 months (range, 3-107 months).


METHODS
The MICOF keratoprosthesis surgery involves 2 procedures. In stage 1, a supporting titanium frame is inserted into the lamellar pocket; a polymethyl methacrylate (PMMA) optical cylinder is implanted 3 months later (stage 2). Data were collected from the preoperative, intraoperative, and postoperative courses. Statistical analysis was performed to identify factors influencing postoperative complications.


METHODS
Visual acuity (VA), keratoprosthesis retention, and significant postoperative complications.


RESULTS
The MICOF keratoprosthesis dramatically improved vision in most patients. The percentage of eyes with postoperative VA of 20/100 or better was 80.7% (67/83) at 6 months after stage 2, 82.4% (61/74) at 1 year, 72.7% (40/55) at 2 years, 78.8% (26/33) at 3 years, 78.9% (15/19) at 4 years, 100% (8/8) at 5 years, 80% (4/5) at 6 years, 100% (2/2) at 7 and 8 years, and 100% (1/1) at 9 years. The most common complication, retroprosthetic membrane formation, occurred in 39 of 85 eyes. The overall keratoprosthesis retention rate was 81.2% at an average follow-up of 34.7 months (range, 3-107 months). Ten eyes presented with elevated intraocular pressure after implantation; 3 of these had underlying glaucoma. All 3 eyes received cyclocryotherapy to control intraocular pressure. Sterile vitreitis occurred in 2 eyes, and retinal detachment occurred in 1 eye.


CONCLUSIONS
The MICOF keratoprosthesis is an effective alternative for patients with corneal blindness and a poor prognosis for penetrating keratoplasty.
Huang
Yifei
Y
Department of Ophthalmology, Chinese PLA General Hospital, Beijing, China.
Yu
Jifeng
J
Liu
Li
L
Du
Gaiping
G
Song
Jing
J
Guo
Huiling
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001187:Artificial Organs; D003315:Cornea; D003318:Corneal Opacity / Q000601:surgery*; D003431:Cross-Cultural Comparison; D005260:Female; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult