Tibial KPro

The clinical results, from the anatomical point of view, are very good, although in the cases of mucosynechial syndromes, which also affect the buccal mucosa, pemphigoids or necrolysing epidermosis (Lyell), the mucosa may retract or necrolyse. In these cases we use the transtarsal method. In elderly patients with osteoporosis the bone may be resorbed and it would be necessary to repeat the procedure using bone from a more favorable area of the tibia, which should be determined with local densitometry. As far as the functional results are concerned, these depend on the conditions of the retina and the optic nerve. If both are in good conditions and the ocular pressure is normal, 20/20 vision may be achieved, although the visual field will never be more then 30º maximum. Indications: We perform this type of keratoprosthesis in patients without suitable teeth, affected with: Physical caustications (metal burns, bomb explosions, fire burns, etc.) Chemical caustications, no matter whether the origin be alkali (worse prognosis because of the glaucoma which usually develops in these cases) or acids (lime, sulphuric acid, sodium hydroxide, etc). Important trauma where the eye had to be covered with skin because of extensive lid destruction. Advanced trachoma with total leucoma and extensive vascularization. Pemphigus and all mucosynechial syndromes which lead to total xerosis Lyell’s syndrome, epidermizing necrolysis Cases of repeated failure of corneal transplantations Anterior segment alterations due to complicated aphakia, bullous keratopathy affecting the entire cornea after previous failure of keratoplasty. Generally, total leucoma with important alterations of the limbus which would not permit survival of a corneal homotransplant.