Orbital implants: potential new directions.

This article reviews orbital implants used to replace an eye after enucleation or evisceration. Advantages of implant placement are described, with discussion of implant and wrap material, and design features that affect clinical outcomes. Implants may be porous or nonporous, pegged for linkage with a cosmetic shell or unpegged, and may be wrapped with a covering material or tissue or unwrapped.

AlphaCor: Clinical outcomes.

Purpose: To study the outcomes of AlphaCor implantation.

Methods: : The AlphaCor artificial cornea is indicated for corneal blindness not treatable by donor grafting. Prospective preoperative and follow-up data were collected.

Screening for drug-induced spoliation of the hydrogel optic of the AlphaCor artificial cornea.

Clinical experience and in vitro investigations demonstrated that AlphaCor, a hydrogel keratoprosthesis, can undergo both surface spoliation and internal depositions/colourations after exposure to certain medications, alone or in combination. While the most commonly used medications have not been associated with spoliation in vivo, many medications are reportedly used due to the complex co-pathologies in many recipients, and regional variations in available medications. We screened a number of drugs used or proposed by surgeons for use in AlphaCor patients to evaluate their potential to cause visually significant optic spoliation (surface or intragel, or colour changes).

Effect of multipurpose solutions for contact lens care on the in vitro drug-induced spoliation of poly(2-hydroxyethyl methacrylate) in simulated aqueous humour.

Drug-induced spoliation of hydrogels as contact lenses or as implants in the anterior eye is a frequent occurrence in clinical practice. This study explores the capacity of three commercial multipurpose solutions for contact lens care to reduce the spoliation of poly(2-hydroxyethyl methacrylate) (PHEMA) specimens exposed to a simulated aqueous humour formulation and to three topical drugs commonly administered after insertion of artificial corneas (Predsol, Optimol and Depo-Ralovera). ReNu MultiPlus (Bausch & Lomb), Complete Blink-N-Cleantrade mark Lens Drops (Allergan) and Complete Protein Remover Tablets dissolved in Complete ComfortPLUS (both from Allergan) were evaluated.

Retroprosthetic membranes in AlphaCor patients: risk factors and prevention.

Purpose: To report retroprosthetic membrane (RPM) formation in association with AlphaCor and identify risk factors for their formation and strategies for prevention and management.

Methods: Review of AlphaCor data and case histories and literature review.

Results: RPMs occurred with AlphaCor in 14 (9.

A risk score as part of an evidence-based approach to the selection of corneal replacement surgery.

Purpose: There is currently no standardized methodology that permits preoperative prediction of the surgical technique or drug regimen for corneal grafting most likely to succeed for an individual patient. A score factor related to the chance of successful penetrating keratoplasty (PK) may assist in standardization of graft outcome reporting and evidence-based management.

Methods: The Risk Score (RS) is based on factors shown to reduce the probability of 1-year survival of conventional PK in increments, using published Australian Corneal Graft Registry data.

Two cases of AlphaCor surgery performed using a small incision technique.

The authors have evaluated the AlphaCor artificial cornea (previously Chirila KPro) in human patients since 1998, utilizing an intrastromal technique requiring extensive corneal lamellar dissection and recommending conjunctival flaps in all cases. Recent availability of low-profile instruments has facilitated a simpler technique, which was first evaluated in two subjects followed for over 1 year prior to recommending the technique for wider adoption. The new technique is presented and illustrated herein, and its benefits and limitations compared with the traditional AlphaCor implantation are discussed.

In vitro drug-induced spoliation of a keratoprosthetic hydrogel.

Purpose: To investigate in vitro the effects of selected drugs on the spoliation of poly(2-hydroxyethyl methacrylate) (PHEMA), a synthetic acrylic hydrogel currently used for the manufacture of a keratoprosthesis, AlphaCor. The experiments were carried out both in the presence of simulated aqueous humor (SAH) and in its absence.

Methods: Disks of PHEMA were incubated and shaken with 9 commonly prescribed drugs at 37 degrees C in sterile conditions for 1 week.

Cataract surgery with the AlphaCor artificial cornea.

Purpose: To review the outcomes of AlphaCor artificial cornea (Argus Biomedical Pty Ltd.) implantation concurrent with or subsequent to cataract surgery.

Setting: Nonrandomized multicenter clinical trial.

Deposits in artificial corneas: risk factors and prevention.

Purpose: To identify risk factors for calcium deposition and pigmented staining within AlphaCor artificial corneas.

Methods: Retrospective analysis of data from 72 AlphaCor implantations was conducted. Histological analysis of explants was performed.

AlphaCor cases: comparative outcomes.

Purpose: To describe clinical outcomes after a novel type of corneal surgery, implantation of an artificial cornea, AlphaCor , and to evaluate outcomes in comparison with alternative keratoprostheses and high-risk grafts.

Methods: Case reports and data from a noncontrolled clinical trial and a literature review.

Results: The probability of AlphaCor retention to 1 year is 80%.

Melting after keratoprosthesis implantation: the effects of medroxyprogesterone.

Purpose: This study was conducted to evaluate the effect of topical medroxyprogesterone (MPG) following KPro implantation in human subjects in whom donor tissue grafts had been contraindicated by high risk of failure.

Methods: Outcomes of implantation of the Chirila KPro, now known as AlphaCor, were reviewed with respect to postoperative MPG therapy. Ten of 45 (22%) patients had received MPG for a period of 12 months, while 35/45 (78%) had not.

Outcomes of implantation of an artificial cornea, AlphaCor: effects of prior ocular herpes simplex infection.

Purpose: To review outcomes of AlphaCor artificial cornea implantation in patients with and without a history of ocular herpes simplex virus (HSV) and to determine whether herpetic eye disease is an indication for AlphaCor surgery.

Methods: Outcomes of the initial 40 implantations were reviewed and stratified by the presence of a history of ocular disease caused by HSV. Outcomes measures (complications, visual acuity gained) were compared.

The Chirila Keratoprosthesis: phase I human clinical trial.

Objective: To undertake a preliminary safety and performance evaluation of an artificial cornea, the Chirila Keratoprosthesis, in human patients.

Design: A prospective, interventional case series.

Participants: Fourteen consecutive patients with blindness of corneal origin not treatable by repeated standard penetrating keratoplasty.