Comparative efficacy evaluation of keratoprosthetics with a Boston type prosthesis, osteoodontokeratoprosthesis and a Fedorov-Zuev prosthesis

Abstract

To date impossibility of keratoplasty with category IV and V corneal opacifation, keratoprosthetics is the only available option to restore useful vision. The most commonly implanted keratoprostheses nowadays are keratoprosthesis «Boston 1 and 2», osteoodontokeratoprosthesis, Fedorov-Zuev keratoprosthesis («MICOF»). This article highlights a comparative evaluation, outcomes and complications of different types keratoprosthesis listed before. Results of implantation of keratoprosthesis «Boston 1 and 2», Osteoodontokeratoprosthesis, Fedorov-Zuev keratoprosthesis «MICOF» (China) collected through literature analysis. The results of implantation of the Fedorov-Zuev keratoprosthesis at the Helmholtz National Medical Research Center for Eye Diseases gained with our own clinical data analysis. In efficacy comparison of keratoprosthesis, we got the following conclusions: when implanting the Boston type keratoprosthesis, functional results are better, fewer complication rates (such as secondary glaucoma and vitreous hemorrhage), but the anatomical outcome is not that good (high necrosis and rejection rates). With osteoodontokeratoprosthesis there are good functional outcomes, but overgrowth of the optical cylinder and vitreous hemorrhage can be seen often. When implanting the FedorovZuev keratoprosthesis using the Helmholtz National Medical Research Center for Eye Disease methods we declare good functional result comparable to osteoodontokeratoprosthesis and the best anatomical result (absence of cases of tissue necrosis over the keratoprosthesis, rejection, exposure of the keratoprosthesis). Keywords: keratoprosthesis, keratoprosthesis, implantation