Korea Seoul-Type KPro: Indications, Contraindications, and Surgical Techniques

Abstract

The Seoul-type keratoprosthesis (Seoul KPro) was designed for use in severe ocular surface disease and end-stage dry eyes. The advanced stages of Stevens-Johnson syndrome, chemical burn, and ocular cicatricial pemphigoid are primary indications for implanting Seoul KPro. The Seoul KPro consists of an optic portion made from polymethyl methacrylate, nonwoven polypropylene skirt for corneal fixation, and haptics of polypropylene for scleral fixation. The main difference between the conventional keratoprosthesis and Seoul KPro is the method of fixation. Seoul KPro uses a method of double fixation to the eyeball to improve its biostability. A corneal lamellar pocket is made after partial trephination of the central cornea. The Seoul KPro is placed into an eyeball after excising the central cornea and delivery of the nucleus with an anterior vitrectomy. Subsequently, both haptics go through each side of the sclera from the inside out at 3 mm away from the limbus using 10-0 polypropylene suture. The skirt is inserted into the previously prepared corneal pocket, and the polypropylene sutures of the haptics are tightly fixed to the sclera when the intraocular pressure of the eyeball is normalized with 10-0 nylon interrupted sutures between the skirt and the lamellar pocket.