Collagen Cross-Linking of the Boston Keratoprosthesis Donor Carrier to Prevent Corneal Melting in High-Risk Patients

Abstract

Collagen crosslinking was previously shown to halt the enzymatic degradation of corneal buttons ex vivo. This study demonstrates the safety and potential benefit of using crosslinked corneal grafts as carriers for the B-KPro, especially in eyes at higher risk of postoperative melt.

Alternatives to eye bank native tissue for corneal stromal replacement

“…In some cases, the implant is then covered by transplanted autologous tissue or eyelid skin (Todani et al, 2011). In order to accommodate the stromal keratocytes, the skirt material should have contiguous voids in the micronmicrometer range for cell integration and maintenance of normal cell-cell contacts (Patel et al, 2006;Robert et al, 2014). However, the posterior surface of the implant should inhibit cellular attachment in order to prevent development of opaque fibrous retroprosthetic membranes (Ament et al, 2009).…”

The Boston keratoprosthesis 2014: a step in the evolution of artificial corneas

“…In order to reduce postoperative tissue melt, carrier corneas have also been cross-linked with ultraviolet (UV) light which has been shown to convey considerable resistance to enzymatic digestion in vitro [8]. Clinically such corneas have been employed as carriers with success [47,69]. For the developing world, however, less expensive alternatives must be sought when autografts are not possible; experiments with γ-radiated porcine xenografts, supplemented with a total conjunctival flap, and other possibilities are presently ongoing [26].…”

A Review of Corneal Collagen Cross-linking – Current Trends in Practice Applications

“…Robert et al reported on cross-linking of the Boston keratoprosthesis donor carrier to prevent corneal melting in a patient with post KPro corneal melt. The patient maintained his visual acuity and showed no evidence of corneal thinning or melt in the first postoperative year [ 141 ].…”