ABSTRACT
PURPOSE: To report the outcome of a retrospective study of the Pintucci Biointegrable Keratoprosthesis (PBIKP) in Asian eyes. MATERIALS AND METHODS: This was a retrospective analysis of 31 eyes of 31 consecutive patients, who underwent surgery with implantation of the PBIKP. The age ranged from 7 years to 65 years, with a mean age of 34 years. The indications for the PBIKP were chemical burns (11 cases); highly vascularized failed grafts (11 cases); severe dry eyes with total vascularized cornea (6 cases); miscellaneous (3 cases). Twenty eight bilaterally blind Asian patients, with vision not exceeding hand motion close to face in the better eye, underwent the classical two-stage procedure to implant the PBIKP. In another three patients, the PBIKP was implanted as a one-stage procedure. All 31 eyes were unsuitable for keratoplasty or had repeated failed keratoplasties. All patients were followed up for periods ranging from 6 months to 7 years, with a mean of 3.2 years. RESULTS: No eye had infection or retro prosthetic membrane, which were common complications in other Keratoprostheses designs. Twenty-four of 31 eyes improved to greater than finger counting at 1.5 metres, enabling the patients to function independently. Four of 31 eyes (13%) improved to 20/200 or better. Twelve of 31 eyes had significant complications. However only a few were vision- threatening. CONCLUSION: With careful patient selection, the PBIKP could prove to be a useful modality of treatment for bilaterally corneally blind Asian patients, whose vision cannot be improved with conventional medical or surgical treatments.
Subject(s)
Absorbable Implants , Adolescent , Adult , Aged , Burns, Chemical/surgery , Child , Corneal Transplantation , Eye Burns/chemically induced , Female , Follow-Up Studies , Humans , India , Male , Middle Aged , Prosthesis Design , Prosthesis Implantation/instrumentation , Retrospective Studies , Treatment OutcomeABSTRACT
The extreme morbidity that a severe chemical burn produces makes it imperative that immediate treatment be instituted for the purpose of restoration of the integrity and transparency of the cornea. The evolution of cicatrisation in severe chemical injuries especially alkali, takes an unfavourable course. Release of collagenase from the newly formed epithelium and fibroblasts of the stroma and lack of required levels of ascorbate in the aqueous humour causes fibroblasts to develop a denatured weak collagen.