Clinical and Experimental Studies of the Epikeratoprosthesis

ABSTRACT

To develop a better clinical application of the epikeratoprosthesis it is important to find the suitablesize of the artificial corneal epithelium, the way of the application of adhesive and the way of complete removal of the epithelium. The authors have an animal experiment basing on above various factors using isobutyl cyanoacrylate as an adhesive and methyl methacrylate as a material of the artificial corneal epithelium. Also we have successfuly performed epikeratoprosthesis operations in five cases of severe bullous keratitis patients. In the animal experimental group, Group 2(isobutyl cyanoacrylate was painted 2 mm broad along the periphery of the lens) showed markedly less extrusion of the artificial corneal epithelium than that of the Group 1 (adhesive was painted 1 mm broad). However, earlier appearance and more frequent incidence of the neovascularization of the cornea were noted in Group 2. On the other hand the result of the clinical 5 cases of the bullous keratitis was excelIent and there was no complications such as extrusion, infection and marked neovassularization for to 9 months, postoperative observation. On the basis of the data obtained from the series of clinical and experimental studies, it was revealed that the epikeratoprosthesis (artificial corneal epithelium) was effective to control the various diseased conditions of the corneal epithelium without significant complication.