Keratoprosthesis in the Filatov Institute: development, study, and results of application

To present results of development and study of the keratoprosthesis method used at the Filatov Institute of Eye Diseases and Tissue Therapy since 1966.

A retrospective case series analysis is used to describe the development of new types of keratoprostheses and methods of implantation as well as different ways of leukoma strengthening.

Keratoprosthesis was performed in 1060 eyes of 1040 patients with leukomas of different etiology: burns, 725 eyes (68.4 %); trauma, 120 eyes (11.3 %); keratitis, Stevens–Johnson syndrome and ocular pemphigoid, 108 eyes (10.2 %); and aphakic/pseudophakic keratopathy, 107 eyes (10.1 %). Visual acuity before keratoprosthesis consisted of light perception in 962 eyes (92 %), and 98 eyes (8 %) had minimal visual acuity (1/200–1/50). Both eyes were blind (visual acuity less than 1/200) in 955 patients (91.8 %). The period of blindness varied from 1 to 52 years. As a result of keratoprosthesis, visual acuity of ≥ 1/200 was restored in 1023 of 1060 eyes (96.5 %). Visual acuity of 20/200–20/20 was achieved in 716 eyes (67.5 %). At the last follow-up visit, visual acuity of ≥ 1/200 was preserved in 806 eyes (76 %), visual acuity of 20/200–20/20 was measured in 583 of 1060 eyes (55 %), and good keratoprosthesis fixation in the cornea was achieved in 986 of 1060 eyes (93 %). The minimal follow-up was 12 months (range: 12 months to 37 years, median: 5 years).

Our techniques of keratoprosthesis effectively restore vision in patients with leukomas that cannot be treated by optical corneal grafting.