Purpose: To survey current knowledge of use of keratoprostheses for visual rehabilitation in the dry eye.
Methods: Sections deal with: (1) when a keratoprosthesis is indicated; (2) classification of keratoprostheses; (3) the osteo-odonto-keratoprosthesis (OOKP), its history, indications and contraindications, patient assessment, surgical technique, results and complications, and (4) the AlphaCor, its design, indications, results and complications.
Results: The choice of keratoprosthesis in the severely dry eye is straightforward, as only one device - the OOKP - will work. With careful assessment, adequate technique, regular follow-up, and early recognition and management of complications, most patients can look forward to many years of sight with an OOKP. In the appropriately managed marginally dry eye, an AlphaCor keratoprosthesis may be considered, although the device should be seen as an alternative to high-risk keratoplasty in multiple graft rejection and vascularised corneae.
Conclusions: KPro surgery is a complex and growing field. Those interested are invited to join the KPro Study Group (www.kpro.org), to add their contribution to the ongoing research and device evaluation.