KeraKlear Artificial Cornea Implantation Assisted by Femtosecond Laser in Eyes With Aniridia

Farias, Charles Costa de; Bezerra, Fernanda Machado; Lamazales, Luiz Luciano; Nosé, Walton; Gomes, José Álvaro Pereira

doi:10.1097/ico.0000000000002998

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…All the included studies reported best corrected VAs, except for the study by Alio et al, 12 who did not specify whether it was best corrected or uncorrected, and for that by Vargas and Shiuey, 15 who reported uncorrected VA only. In addition, de Farias et al 16 did not report the exact VA in the period between the operation and 3 years thereafter, and one of their patients underwent phacoemulsification and Intraocular lens implantation surgery during the follow-up period. Alio et al, 12 on the other hand, only displayed the last follow-up VAs of patients who did not experience any complication (6 patients improved from light perception to counting fingers, 1 patient from light perception to hand motion, 1 patient from hand motion to counting fingers, and 1 patient from counting fingers at 10 cm to counting fingers at 2 m).…”

Section: Resultsmentioning

confidence: 99%

“…One year after the operation, de Farias et al 16 reported a case of folding of the KK that was believed to be related to trauma. This Kpro needed to be replaced, and after that, no further complications were reported.…”

Section: Resultsmentioning

confidence: 99%

“…In both of their studies, Alio et al did not specify for how long these therapies were continued. de Farias et al 16 and Conlon et al, 13 on the other hand, prescribed topical prednisolone acetate for 2 months (with a tapering regimen) and a topical antibiotic (gatifloxacin q.i.d. and moxifloxacin q.i.d.…”

Section: Postoperative Managementmentioning

confidence: 99%

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Nonpenetrating Foldable Intrastromal Keratoprosthesis: A Review of the Literature

Kilian,

Lammer,

Roberts

et al. 2024

Cornea

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Purpose: To review the literature focusing on the clinical outcomes of KeraKlear (KK) (KeraMed), a foldable intrastromal keratoprosthesis. Methods: We searched 6 databases using 4 keywords: KeraKlear, Foldable Keratoprosthesis, Intrastromal Keratoprosthesis, and Non-penetrating Keratoprosthesis. Included studies had to be conducted in vivo on humans, published until January 3, 2023, and had to investigate the implantation of the KK. Eyes were considered at high risk of keratoprosthesis retention failure whenever there was an active inflammatory ocular surface disorder or in case of previous KK failure. We aimed at recording the postoperative complications, rate of prosthesis retention, and mean improvements in visual acuity. Results: We identified 144 publications, 6 of which (38 eyes) met the inclusion criteria. No randomized controlled trials were found, and some studies had significant limitations regarding sample size and follow-up duration. With a mean follow-up of 28 ± 18.8 months, postoperative complications of any kind occurred between 0% and 50% and 24% had an implant extrusion/needed a reoperation. The mean postoperative visual acuity improvement on the last follow-up was −0.83 ± 0.27 LogMAR, that is, −0.57 ± 0.3 for high-risk and −1.03 ± 0.25 for low-risk eyes, whereas 1 year after implantation, 50% of the prostheses were retained in the former and 81% in the latter group. None of the eyes developed glaucoma, endophthalmitis, or expulsive hemorrhages; none had to be eviscerated/enucleated. Conclusions: Despite the limited quality and quantity of evidence, the available literature seems to suggest the KK to be a valuable tool in the treatment of complicated corneal disorders. Because in many parts of the world, the access to corneal transplantation is limited, this prosthesis could represent a valid alternative.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Nonpenetrating Foldable Intrastromal Keratoprosthesis: A Review of the Literature

Kilian,

Lammer,

Roberts

et al. 2024

Cornea

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“…[ 110 ] A case report used partial thickness corneal incisions with ICRS software as an alternative method for drug delivery in nonresponding intrastromal infectious keratitis. [ 111 ] Other case reports use FSL-assisted intrastromal pockets to implant intrastromal KeraKlear artificial cornea in congenital aniridia[ 112 ] or insert silicon oil as palliative management of bullous keratopathy in blind eyes. [ 113 ]…”

Section: Other Proceduresmentioning

confidence: 99%

Femtosecond laser applications in corneal surgery

Mohamed-Noriega,

Morales-Wong,

Navas

et al. 2023

Taiwan J Ophthalmol

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Femtosecond laser (FSL) applications in corneal surgery have increased since its inception. Corneal surgery has undergone a tremendous transformation thanks to the introduction of FSL technology. This laser makes precise, three-dimensional incisions while causing minimal damage to surrounding tissue. This review updates and summarizes current and upcoming FSL applications in corneal surgery, current commercially available FSL, and its respective applications. Refractive surgery applications include laser in-situ keratomileusis flaps, refractive corneal lenticule extraction such as small incision lenticule extraction, astigmatic keratotomy, intracorneal ring segments tunnels for keratoconus including corneal allogenic intrastromal ring segments, and presbyopia treatments with intrastromal pockets for corneal inlays and intrastromal incisions (INTRACOR). Keratoplasty applications include penetrating keratoplasty trephination; superficial and deep anterior lamellar keratoplasty trephination, lamellar dissection, and tunnel creation; posterior lamellar keratoplasty donor and recipient preparation; Bowman layer transplantation donor, and recipient preparation; and stromal keratophakia. Other applications include conjunctival graft preparation in pterygium surgery, and keratopigmentation (corneal tattooing). FSL is a surgical instrument widely used in corneal surgery because it improves reproducibility and safety in many procedures.

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New horizons in aniridia management: Clinical insights and therapeutic advances

Gour,

Tibrewal,

Garg

et al. 2023

Taiwan Journal of Ophthalmology

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Congenital aniridia is a rare genetic eye disorder characterized by the complete or partial absence of the iris from birth. Various theories and animal models have been proposed to understand and explain the pathogenesis of aniridia. In the majority of cases, aniridia is caused by a mutation in the PAX6 gene, which affects multiple structures within the eye. Treating these ocular complications is challenging and carries a high risk of side effects. However, emerging approaches for the treatment of aniridia-associated keratopathy, iris abnormalities, cataract abnormalities, and foveal hypoplasia show promise for improved outcomes. Genetic counseling plays a very important role to make informed choices. We also provide an overview of the newer diagnostic and therapeutic approaches such as next generation sequencing, gene therapy, in vivo silencing, and miRNA modulation.

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KeraKlear Artificial Cornea Implantation Assisted by Femtosecond Laser in Eyes With Aniridia

Cited by 3 publications

References 8 publications

Nonpenetrating Foldable Intrastromal Keratoprosthesis: A Review of the Literature

Nonpenetrating Foldable Intrastromal Keratoprosthesis: A Review of the Literature

Femtosecond laser applications in corneal surgery

New horizons in aniridia management: Clinical insights and therapeutic advances

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