Abstract
One of the major problems of keratoprosthesis (KPro) is postoperative expulsion resulting from inadequate haptic fixation. To overcome this obstacle, a new design was conceived using a retrocorneal fixation. An earlier version of our KPro was made of two pieces: an optical element threaded in a surrounding haptic. Both pieces were made of medical grade PMMA. Although encouraging results were obtained, some anatomic failures occurred (20% at 5 years). To improve fixation and sealing, a biocolonizable skirt was recently added to the keratoprosthesis. This skirt should prevent migration of biocontaminants inside the eye. Made of porous PTFE, the skirt was ultrasonically held inside a one-piece PMMA keratoprosthesis by ultrasonic microwelding. Thus far, implantations carried out in 8 patients show a good tolerance.