Challenges to globalizing keratoprothesis surgery

This presentation will address the current status of keratoprosthesis globalization, world‐wide, with special attention to use in less economically developed countries. The author will review the existing literature, and discuss obstacles and opportunities encountered in implementation of keratoprosthesis surgery in blind, indigent patients, world‐wide. Implantation of keratoprostheses, including the modified osteo‐odonto keratoprosthesis and the Boston keratoprosthesis, is increasing internationally, and in particular, in less economically developed nations with large proportions of indigent, corneal blind patients. Based on the published literature, specific complications, such as device extrusion and infectious endophthalmitis, may be more common in these settings. Increased implantation of keratoprosthesis use in less economically developed countries will bring new challenges. We can expect increased reports of severe complications after keratoprosthesis implantation, particularly in the poorest patients. New designs and approaches are needed before keratoprosthesis implantation can be fully globalized.