Implantation of Boston keratoprosthesis after lime burns

Abstract

The case report describes a 76 - year old patient with bilateral corneal blindness after lime burns and subsequent repeated unsuccessful keratoplasty, who regained vision after 16 years by implantation of Boston keratoprosthesis. Video shows this challeging surgery. At first the opaque cornea was trephined. Then under the temporary silicone keratoprosthesis phacoemulsification with hydrophobic monofocal intraocular lens implantatio n was performed. The temporary silicone keratoprosthesis was removed and Boston KPRO artificial cornea attached to patient own central cornea was sutured to the periphery of patient’s cornea by interrupted radial Nylon 10 - 0 sutures. So there was no need to use corneal graft from eye bank. The surgery was concluded by pressurizing the eye and intravitreal injection of triamcinolon, antiVEGF and cefuroxim for cystoid macular oedema and endophtalmitis prevention. Visual acquity has improved from hand motion t o 0,4 decimal on 1 year follow - up.