The EBAI CME 2013 - 21st and 22nd of September 2013, Golden Valley Resort, Ghodbunder Road, Thane West, Mumbai.

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KeratoprosthesisKeratoprosthesis
– When, Which,– When, Which,
How?How?Dr. Quresh B. MaskatiDr. Quresh B. Maskati
Maskati Eye Clinic – Mumbai 400004Maskati Eye Clinic – Mumbai 400004

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IntroductionIntroduction
There are many different types of Kpro inThere are many different types of Kpro in
the market today. The ones most widelythe market today. The ones most widely
used are the :used are the :
 Singh-Worst Champagne cork KproSingh-Worst Champagne cork Kpro
 The MOOKP of FalcinelliThe MOOKP of Falcinelli
 The Pintucci Kpro with a dacron meshThe Pintucci Kpro with a dacron mesh
skirt hapticskirt haptic
 The Dohlman or Boston KproThe Dohlman or Boston Kpro

3. Should every OpaqueShould every Opaque
Cornea be offered aCornea be offered a
Kpro?Kpro?
 No, corneal transplant gives veryNo, corneal transplant gives very
good results in a majority of cases-good results in a majority of cases-
both lamellar and full thicknessboth lamellar and full thickness
graftsgrafts
 In infective keratitis, only naturalIn infective keratitis, only natural
cornea will save the eyecornea will save the eye
 Successful corneal transplants haveSuccessful corneal transplants have
better field of vision than Kprosbetter field of vision than Kpros
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25 years post PK
11mm Th PK

4. What are theWhat are the
Indications for BostonIndications for Boston
Kpro?Kpro?
 Any vascularised, failed graftAny vascularised, failed graft
 Any opaque cornea withAny opaque cornea with
vascularisation/stem cell deficiencyvascularisation/stem cell deficiency
 Eye with good visual potential – noEye with good visual potential – no
glaucoma, normal posterior segment,glaucoma, normal posterior segment,
anterior segment not severely disfiguredanterior segment not severely disfigured
 Good tear secretion, good lid blinkGood tear secretion, good lid blink
and appositionand apposition
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5. Which patients shouldWhich patients should
not be referred fornot be referred for
Boston Kpro?Boston Kpro?
 Those with poor tear secretionThose with poor tear secretion
 Those with keratinised corneasThose with keratinised corneas
 Those with history of previous cornealThose with history of previous corneal
meltsmelts
 Those with poor lid blinks, mal-opposedThose with poor lid blinks, mal-opposed
lidslids
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6. Indications forIndications for
Pintucci KproPintucci Kpro
 Bilaterally blind patients with at leastBilaterally blind patients with at least
accurate perception of light in one eyeaccurate perception of light in one eye
 B scan showing: attached retina, no deepB scan showing: attached retina, no deep
cupping of glaucoma; not pre-phthisicalcupping of glaucoma; not pre-phthisical
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7. Contra-indications forContra-indications for
all Kprosall Kpros
 Patient unable to follow up with somePatient unable to follow up with some
eye doctoreye doctor
 Patients unable to understandPatients unable to understand
importance of compliance to treatmentimportance of compliance to treatment
regimeregime
 Patients unable to afford myPatients unable to afford my
unreasonably high feesunreasonably high fees
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8. Pintucci Kpro videoPintucci Kpro video
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9. Boston Kpro videoBoston Kpro video
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10. Thank you for yourThank you for your
attention!attention!
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 Now you hopefully know the answers to:Now you hopefully know the answers to:
 WhyWhy a Kpro for a patient?a Kpro for a patient?
 WhichWhich Kpro for a particular patient ?Kpro for a particular patient ?
 HowHow these Patients are operated?these Patients are operated?
 WhatWhat is the likely outcome?is the likely outcome?