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FinDM II - On the register-based measurement of the prevalence and incidence of diabetes and its long-term complications. Keratoprosthesis implantation is a procedure that involves full-thickness removal of the cornea and replacement by an artificial cornea. Figure 16: Pre- and post-operative appearance of a Boston Type I KPro device for Stevens-Johnson syndrome.
Figure 18: Anterior segment optical coherence tomography demonstrating the appearance of a Boston Type I Kpro with healthy corneal tissue surrounding the device.
Figure 19: Boston Type II KPro for severe ocular cicatricial pemphigoid (A) and Stevens-Johnson syndrome (B). Mark the center of the host cornea using a Sinskey hook and measure the cornea to determine the appropriate transplant size.


Assemble the keratoprosthesis by sandwiching the corneal graft between the front and back plates of the KPro device. Create a paracentesis, in the trephination groove or the corneal periphery, and inject Healon into the anterior chamber to preserve anterior chamber depth and stability. After using a blade to enter the eye through the trephination groove, resect the host cornea tissue using curved corneal scissors. Because the KPro is a foreign body, there is risk of infection or extrusion of the device.
Post-operative glaucoma is common and intraocular pressure is difficult to evaluate as the hard optic makes traditional tonometry impossible.
For this reason, glaucoma tube shunts are typically placed at the time of the corneal transplant at the University of Iowa.


The Diaton is currently the preferred way to measure intraocular pressure in these patients in our institution.
Patients can form retroprosthetic membranes requiring treatment with a Nd:YAG laser or surgical membranectomy (21).



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