Moscow eye microsurgery complex in Russia keratoprosthesis in Beijing

Abstract

Purpose: To evaluate the efficacy and preliminary safety of the Moscow Eye Microsurgery Complex in Russia (MICOF) keratoprosthesis in eyes with complicated corneal opacities unsuitable for keratoplasty.

Design: Retrospective review of consecutive clinical case series.

Participants: We analyzed 85 eyes of 85 patients who previously underwent MICOF keratoprosthesis implantation at the Chinese PLA General Hospital between April 1, 2000, and August 31, 2009. The mean follow-up after MICOF keratoprosthesis implantation (measured after the second stage of the implantation) was 34.7 months (range, 3-107 months).

Methods: The MICOF keratoprosthesis surgery involves 2 procedures. In stage 1, a supporting titanium frame is inserted into the lamellar pocket; a polymethyl methacrylate (PMMA) optical cylinder is implanted 3 months later (stage 2). Data were collected from the preoperative, intraoperative, and postoperative courses. Statistical analysis was performed to identify factors influencing postoperative complications.

Main outcome measures: Visual acuity (VA), keratoprosthesis retention, and significant postoperative complications.

Results: The MICOF keratoprosthesis dramatically improved vision in most patients. The percentage of eyes with postoperative VA of 20/100 or better was 80.7% (67/83) at 6 months after stage 2, 82.4% (61/74) at 1 year, 72.7% (40/55) at 2 years, 78.8% (26/33) at 3 years, 78.9% (15/19) at 4 years, 100% (8/8) at 5 years, 80% (4/5) at 6 years, 100% (2/2) at 7 and 8 years, and 100% (1/1) at 9 years. The most common complication, retroprosthetic membrane formation, occurred in 39 of 85 eyes. The overall keratoprosthesis retention rate was 81.2% at an average follow-up of 34.7 months (range, 3-107 months). Ten eyes presented with elevated intraocular pressure after implantation; 3 of these had underlying glaucoma. All 3 eyes received cyclocryotherapy to control intraocular pressure. Sterile vitreitis occurred in 2 eyes, and retinal detachment occurred in 1 eye.

Conclusions: The MICOF keratoprosthesis is an effective alternative for patients with corneal blindness and a poor prognosis for penetrating keratoplasty.