Alphacor: Indications, contraindications, techniques and outcomes

Abstract

Alpha Cor is a biocompatible, flexible, one-piece artificial cornea for patients whose corneal blindness is unlikely to be managed by means of standard penetrating keratoplasty. It is made from the hydrogel poly(2-hydroxyethyl methacrylate) (PHEMA) and utilises the different physical forms of PHEMA obtained by varying the water concentration during manufacture. AlphaCor has a core-and-skirt design: a central transparent optic surrounded by a white porous skirt that allows biointegration. The entire device has a diameter of 7.0 mm, a thickness of 0.6 mm and surface curvatures that result in appropriate refractive power when implanted. It is placed within a lamellar corneal pocket with tissue posterior to the optic being removed at the time of implantation (stage I surgery) and the tissue anterior to the optic being removed secondarily (stage II surgery). The porous skirt remains enclosed within corneal stromal tissue, with which it biointegrates due to cellular colonisation and collagen deposition. In this chapter, we will review the indications and contraindications for AlphaCor implantation, the essential surgical techniques and goals and our personal experience and outcomes with this device.