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More than 50 years of experience with keratoprostheses
Author(s) -
BARRAQUER J
Publication year - 2008
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2008.6333.x
Subject(s) - keratoprosthesis , medicine , visual acuity , blindness , prosthesis , ophthalmology , accidental , cornea , bullous keratopathy , surgery , optometry , physics , acoustics
We started to use acrylic corneal prostheses experimentally in 1955, principally in eyes considered functionally lost or after several attempts of other keratoplastic procedures had failed. In our first 15 cases a Dorzee prosthesis or a modified Dorzee prosthesis (Barraquer‐Cardona) had been used, in three cases some useful vision was obtained for several months or even up to 4 years. However, the expulsion rate was high, mainly due to the lysis of the corneal borders around the prosthesis. The communication of Strampelli’s first technique of osteo‐odonto‐keratoprosthesis, using a “live” support encouraged us to continue our experimentation. A case of bilateral blindness in a 50 year old patient, due to mine explosion in 1941 (Second World War) was first seen in 1965, 25 years after the accident. The right eye was lost due to retinal detachment, the left eye was aphakic, with opaque cornea due to explosion impacts and anterior synechiae due to old perforations. In 1965 osteo‐odonto‐keratoprosthesis, using Strampelli’s first technique, was performed with good recuperation of vision (0.4) for 10 years. Different aspects and details of the case are presented and commented. Unfortunately in 1975 necrosis of the bone support developed and reconstructive keratoplasty had to be performed. The patient remained with very low visual acuity (0.03) and a very reduced visual field. The author considers that this result, obtained with the very limited facilities available more than 40 years ago, confirms and justifies that experimentation in this field must continue, making use of all technological, surgical, pharmacological and research facilities available today.