![]() ![]() ![]() In a surgical procedure called limbal cell transplantation, extraction of stem cells from the healthy contralateral eye of a patient or from a relative in the family is transplanted into a patient's eye with corneal degeneration, blindness, or some other ocular disease. In recent years, new techniques that can restore vision in certain types of blindness have come to the fore. 1-32), which is a source of stem cells for corneal epithelium. The cornea covers the eye globe and a narrow zone between the cornea and the conjunctiva known as the limbus ( Fig. Michael Cohen Jr., in Orthognathic Surgery, 2014 Making Blind People See Again Given the increased risk of graft failure with each subsequent regraft and the decreased time of survival of each subsequent regraft, the Boston keratoprosthesis should be considered in patients motivated to obtain visual rehabilitation. The Boston keratoprosthesis may be a very viable option for patients who have failed prior penetrating keratoplasty for these non-cicatrizing corneal diseases. 31 There were no device extrusions observed during the follow-up period. 31 The authors found that 15 eyes (88%) achieved a best-corrected visual acuity between 20/25 and 20/70 during the postoperative period, and 11 eyes (73%) were able to maintain that level of visual acuity at the last follow-up visit (median, 17 months range 6–72 months). 29,30 In a series of 17 failed traditional penetrating keratoplasties in 14 patients with underlying herpetic keratitis, the outcomes were quite favorable after placement of a Boston keratoprosthesis. Patients who are at particularly high risk of corneal allograft failure are those with underlying herpes simplex keratitis. They tend to have a better visual outcome at 5 years and are less likely to lose best-corrected visual acuity of 20/200 or better after surgery. 16 These are patients who have failed traditional penetrating keratoplasty and have underlying diseases ranging from corneal dystrophies or degenerations to bacterial and viral keratitis. Surgical outcomes in patients with non-cicatrizing ocular surface conditions carry the best prognosis after keratoprosthesis surgery. Mannis, in Ocular Surface Disease: Cornea, Conjunctiva and Tear Film, 2013 Graft Failures and Keratoprosthesis Surgery ![]()
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