In cases where a traditional corneal transplant is unsuccessful, an artificial corneal transplant can often be performed. Indeed, this may be the only treatment option for patients who have a high risk of tissue rejection from donor transplants or who have had other problems with corneal tissue grafts. New York Eye and Ear Infirmary of Mount Sinia (NYEE) is among the most active centers in the nation—and one of few in the New York metropolitan area—to perform these procedures.
There are several types of artificial corneal transplants. Our implant surgeons use the Boston keratoprosthesis, the most commonly grafted artificial cornea in the United States and around the world. The Boston keratoprosthesis has a plastic center attached to a human donor cornea, which is sutured into the patient’s eye. The device has excellent tissue tolerance and optical properties. Clinical advantages include minimal graft rejection and typically excellent vision. Disadvantages include a relatively short track record, the need to use antibiotic drops and wear a soft contact lens for life, and difficulty managing and treating glaucoma associated with severe corneal disease. In addition, the risk of infection is far greater than with traditional keratoplasty.
Boston keratoprosthesis surgery is performed using local or general anesthesia in the operating room. Patients typically notice improvements in their vision in the days to weeks following the procedure. As part of their long-term post-operative care, recipients are prescribed antibiotic eye drops to prevent infection. Medications to control inflammation or glaucoma may also be prescribed.