Familiarity with Treatment

Keratoprosthetics involves the use of an artificial cornea (keratoprosthesis) to replace a damaged or diseased cornea. This procedure is often used when traditional corneal transplants are not viable. Combining this with cataract surgery and a corneal transplant can address multiple eye issues in one procedure.

Procedure Explanation

1. Anesthesia:
   • Local or general anesthesia is administered to numb the eye.
2. Preparation of Donor and Recipient Tissue:
   • A femtosecond laser is used to create precise cuts in both the donor corneal tissue and the recipient’s cornea.
3. Cataract Surgery:
   • The cloudy natural lens is removed through a small incision.
   • An intraocular lens (IOL) is implanted to replace the natural lens, providing clear vision.
4. Placement of Keratoprosthesis:
   • The artificial cornea is placed into the prepared site on the recipient’s eye.
   • The donor tissue is then grafted around the keratoprosthesis to secure it in place.
5. Stitching:
   • Fine sutures are used to secure the graft and keratoprosthesis in place.
6. Post-Surgery:
   • The eye is covered with a protective shield to aid healing.

Who is it Suitable For?

• Patients with severe corneal diseases not amenable to traditional corneal transplantation.
• Individuals with conditions such as severe chemical burns, ocular cicatricial pemphigoid, or multiple failed corneal transplants.
• Patients with severe corneal scarring or opacification.
• Individuals with cataracts that need to be addressed simultaneously.

Who is it Not Suitable For?

• Patients with active eye infections or severe inflammation.
• Individuals with conditions that may affect healing, such as uncontrolled diabetes.
• Patients who are not suitable candidates for surgery due to other health conditions.

Advantages

• Vision Restoration: Can significantly improve vision in patients with severe corneal damage and cataracts.
• Precision: The femtosecond laser allows for highly precise cuts, improving the fit and integration of the graft.
• Durability: The keratoprosthesis provides a long-lasting solution for corneal blindness.
• Reduced Rejection: Lower risk of rejection compared to traditional corneal transplants.
• Combined Procedure: Addresses multiple eye issues in one surgery, reducing the need for multiple procedures.

Complications

• Rejection: Although reduced, there is still a risk of the body rejecting the graft.
• Infection: Risk of postoperative infection.
• Glaucoma: Increased intraocular pressure.
• Graft Failure: The transplanted tissue may fail over time.
• Vision Changes: Possible temporary or permanent changes in vision.
• Bleeding: Possible bleeding during or after surgery.

Previous Care

• Preoperative Assessment: Comprehensive eye examination and measurements.
• Medication Review: Adjustments to current medications, especially those affecting healing.
• Health Evaluation: General health check to ensure suitability for surgery.

Aftercare

• Medications: Use prescribed eye drops to prevent infection and control inflammation.
• Follow-Up Visits: Regular check-ups to monitor healing and detect any complications.
• Activity Restrictions: Avoid strenuous activities and protect the eye from injury.
• Vision Monitoring: Report any changes in vision or discomfort to your ophthalmologist immediately.