Fyodorov-Zuev keratoprosthesis is an effective means of managing repeated corneal graft failure.

Penetrating keratoprosthetics of thin irregular corneal leukomas requires several preliminary surgical procedures. To reduce the period of visual rehabilitation and number of operations for this group of patients a new type of surgical treatment, combining keratoplasty and keratoprosthetics, was developed in 1996. This technique was named “K‐Pro – cornea” complex transplantation. Methods: At first collagen‐crosslinking procedure was performed for allogeneic preserved donor cornea according to the Zurich protocol with the use of UV‐X‐1000 (IROC Innocross, Switzerland) and 1% riboflavin solution (Dextralink). Further Fedorov‐Zuev keratoprothesis was implanted into the modified cornea. Resulting complex was cut out of the corneal‐scleral rim with 9,0 mm trephination blade. Recipients corneal disk of the same diameter was removed and all procedures, necessary for the lens and anterior chamber, were performed before placing “K‐Pro – cornea” complex into the bed and fixing it with interrupted sutures. All in all 64 patients with vascularized leukomas were treated with the use of this technique. Observation period was up to 10 years. Results: Best spectacle‐corrected visual acuity (BSCVA) rose from pr. l. certae before surgery to 0,01‐1,0 after. Following complications were met in the postoperative period: retroprothesis membrane (99,9%), aseptic necrosis (39,6%), K‐Pro protrusion (11%). Conclusions: Developed technique of transplantation of “K‐Pro – cornea” complex enabled to reduce the number of main and preliminary surgical procedures and the period of patients visual rehabilitation. Key words: K‐Pro, keratoplasty, collagen‐crosslinking.

Purpose To present the development and current status of keratoprosthesis surgery in Eastern Europe. Methods Collection of data from coauthors and other surgeons involved in k‐pro surgery. Results Large numbers of surgeries were performed in Filatov's Institute in Odessa (Ukraine), where over 1000 different types of devices developed by Puchkovskaya, Yakimienko and Golubenko were imlanted since 1966. The last model, s.c. "universal separable device" was implanted in over 750 with the best results (extrusion occured in about 2.5% cases). K‐pro devices in Russia were mostly developed by S. Fyodorov Z. Moroz, V. Zuyev, ?. Krasnov, V. Volkov, R. Gundorova, N. Ushakov and V. Bedilo. Over 1500 surgeries sine 1969 resulted in the visual aquity improvement in 94% of cases. Haptics were made of titanium, stainless steel and also biocompatible materials (xenopericardium). In Poland about 100 surgeries were performed using mostly Russian and Ukrainian devices. The results were less favorable than in countries of origin. Small numbers were also implanted in other East European states. Conclusion In former Soviet Union keratoprosthesis surgery was well developed in selected centers (Moscow, Odessa). Surgeons in these places have gained extraordinary experience performing hundredes of surgeries. The results presented by the authors were excellent, however they were less favorable in the hands of surgeons from other countries.