Aachen-Keratoprosthesis as temporary implant. Case report on first clinical application

Background: The Aachen-Keratoprosthesis was designed to serve as a permanen t keratoprosthesis, modeling natural corneal physical properties as closely as possible. Prior to permanent application in patients, keratoprostheses are commonly tested in animal models to assess biochemical and biomechanica l compatibility. However, immune and inflammatory responses acquired throug h animal experimentation are difficult to extrapolate in order to develop a predictable and generalized outcome in humans. Therefore, this preliminary report includes results following a temporary implantation of the Aachen-K eratoprosthesis in a patient during vitreoretinal surgery to assess the lon g-term prospect of application as a permanent artificial cornea. Patient and Methods: A 43 year old man presented with a ruptured right eye resulting in an opaque cornea and retinal detachment A soft silicone rubber keratoprosthesis, the Aachen-Keratoprosthesis, was temporarily implanted S ubretinal membranes were removed and the total retinal detachment was reatt ached. Liquid perfluorocarbon and silicone oil were used. The temporary ker atoprosthesis was replaced by a 7 mm corneal graft after completion of surg ery. Results: The Aachen-Keratoprosthesis was securely positioned into the treph ined hole. It allowed complete visualisation of vitreous, retina and thus c ontrolled manipulations in the vitreous cavity up to the extreme periphery. Leakage across the trephination-prosthesis interface was minimal. Conclusion: We report the first temporary application of an innovative kera toprosthesis. its flexibility and good optical qualifies allow visualisatio n and control of intraoperative procedures. This temporary pilot study of t he Aachen KPro encourages further investigation of the Aachen KPro as a per manent replacement for a diseased cornea.