MAR 15, 2016
In this video, the authors evaluate the safety and efficacy of collagen cross-linking (CXL) for achieving increased cornea rigidity and reduced enzymatic digestion in the vehicle cornea of Boston keratoprosthesis type 1 (Kpro-1). This report includes 11 cases (5 with repeat cornea graft failure, 4 with ocular cicatricial pemphigoid, and 2 with chemical burn), all of which received donor vehicle CXL intrastromally and superficially. Visual acuity, corneal surface, and donor vehicle cornea stability was evaluated up to 7.5 years. Mean uncorrected distance visual acuity improved from light perception to 20/60. No eye developed melt or infection, especially on the vehicle cornea. Pretreatment with intrastromal and superficial CXL in Kpro-1 appears to be a safe and effective adjunctive treatment for increased vehicle donor cornea rigidity and resistance to enzymatic degradation.