New keratoprosthesis a viable alternative to corneal transplant

A new epidescemetic keratoprosthesis (KeraKlear Kpro, KeraMed Inc.), implanted without total corneal trephination, is a viable alternative to corneal transplantation, according to researchers from Spain, Egypt, and Kuwait reporting in the British Journal of Ophthalmology.

The researchers studied 15 eyes in patients in whom penetrating keratoplasty (PK) had a high risk of failure or who had conditions that made a poor prognosis likely for PK. Surgical planes that were adequate for implantation with the keratoprosthesis were created using a femtosecond laser, and the keratoprosthesis was implanted either intralamellar (11 eyes) or epidescemetical (4 eyes). The patients were followed from 7 to 21 months.

The anatomical outcome was excellent in all four eyes in which the implant was inserted using the epidescemetical technique. The anatomical outcome was excellent in five eyes, with no complications, in patients who received the implant via the intralamellar technique. The other six eyes in this group developed complications that included deep corneal inflammatory membrane, totally vascularized cornea, extrusion of the keratoprosthesis, and corneal melting. All of these complications were successfully managed and no eyes were lost. 

Next: Endophthalmitis: less risk from injectable IOLs than foldable

Researchers in the U.K. say that using injectable intraocular lenses (IOLs) rather than forceps-inserted foldable IOLs can significantly reduce the risk of cataract patients developing postoperative endophthalmitis.

Related: New keratoprosthesis a viable alternative to corneal transplant

The researchers conducted an 8-year, single-centre, retrospective cohort study of 25,410 cataract operations. They found that patients who received an injectable IOL had a rate of postoperative endophthalmitis (0.008%) that was significantly lower than that of patients who received a forceps-inserted foldable IOL (0.081%). Out of the total of 25,410 operations there were 12 cases of postoperative endophthalmitis.

The results were published in the British Journal of Ophthalmology.