Artificial corneasBMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7187.821 (Published 27 March 1999) Cite this as: BMJ 1999;318:821
Risks of complications are high now, but better materials are on the way
- Bruce Allan, Consultant ophthalmologist, director of biomaterials research
- Moorfields Eye Hospital, London EC1V 2PD
Corneal disease is the second commonest cause of world blindness1 and often occurs in the context of a badly damaged ocular surface. Patients with dry eyes and vascularised corneal scarring resulting from, for example, trachoma or chemical injuries have virtually no prospect of retaining a clear corneal allograft.2 Techniques for implanting a synthetic corneal replacement (keratoprosthesis) offer hope to this desperate group of patients, who are often blind for many years. Understandably, press and public imagination is captured by news of possible restoration of sight in these cases. The pioneering spirit of tackling unmet clinical need has been emphasised in recent newspaper reports,3–5 but uncertainty surrounding outcomes is barely mentioned.
Keratoprosthesis techniques reported recently in the British press are not new. Implantation methods and the devices themselves have not materially altered since the 1960s. Devices consist of a porous outer skirt element (Dacron for the Pintucci keratoprosthesis recently implanted in Nottingham and autologous tooth for the Strampelli keratoprosthesis used …