KERATOPROSTHESIS WITH RETROCORNEAL FIXATI ON - RESULTS IN 30 CASES

Keratoprosthesis is the last solution for corneally blind patients who cannot benefit from corneal grafts. The indications are limited to bl ind patients with monophthalmia and bilateral problems that are otherw ise untreatable. After implanting the Choyce and Strampelli's devices for more than 10 years, we abandoned these anterior fixation technique s and now use a keratoprosthesis in which the sole mechanical fixation consists of a posterior support which is subsequently sealed by the f ibrosis produced by the endothelial-Descemet tissues. This new prosthe sis is made of two pieces, an optic and an haptic fashioned out of CQ- PMMA. TO minimize expulsion, the haptic outer diameter is greater than the central corneal orifice through which the optic is inserted and s crewed into the haptic. The keratoprosthesis refractive power can be e asily adjusted after lensectomy by changing the 40 D for a 63 D optic. The prosthesis is implanted in a single step surgical procedure, and can be implanted in phakic eyes while respecting the physiology and an atomy of these fragile eyes. This single step procedure reduces the us ual repeated operations required when using, other techniques. We oper ated 12 cases of pseudopemphigus, 9 cases of burns, 7 cases of trachom a, and 2 cases of pseudophakic oedema with good cosmetic and visual re sults with a follow-up ranging from several months to more than 3 year s. The results obtained with this new keratoprosthesis are encouraging . The results have been analysed and classified into : anatomic and fu nctional success 20 cases, anatomic success and functional failures 4 cases, anatomic failures 6 cases.