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Jin Hak Lee, MD; Won Ryang Wee, MD; Eui Sang Chung, MD; Hee Young Kim, MD; Seong Hwae Park, MD; Young Ha Kim, PhD

Arch Ophthalmol. 2000;118:1673-1678.

Objective  To develop a newly designed double-fixed keratoprosthesis (Seoul-type keratoprosthesis [S-KPro]) and to assess its mechanical stability and biocompatibility.

Methods  Twenty-five rabbits were divided into 4 groups by fixation technique, amniotic membrane (AM) implantation, and skirt material. The eyes were studied with the use of slitlamp, light, and electron microscopy. Stress testing was performed. In addition, 2 human subjects underwent S-KPro implantation. Best-corrected visual acuity was checked, and ophthalmic examination was performed.

Results  The average retention period of the group receiving double-fixated polyurethane–S-KPro with AM was longer (>24 weeks) than that of the others. Fibroblast invasions were found in polyurethane pores but not in polytetrafluoroethylene (Gore-Tex) pores on light microscopy. The minimal pressure that induced aqueous leakage was greater than 250 mm Hg in all of the tested eyes. Two human subjects have maintained a good postoperative condition for 18 and 8 months.

Conclusions  The double-fixation technique of applied S-KPro and AM appears to be helpful in improving the stability of the keratoprosthesis. Polyurethane with relatively large pore size (40 µm) may be used successfully as a material for the keratoprosthesis skirt.

Clinical Relevance  Our results may be important for improving the clinical outcome of keratoprosthesis.

From the Departments of Ophthalmology (Drs Lee, Wee, Chung, and H. Kim) and Pathology (Dr Park), Seoul National University College of Medicine, and the Korea Institute of Science and Technology (Dr Y. Kim), Seoul, South Korea.

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