Artificial cornea: Advantages, Risks and News


Artificial cornea transplant is the last frontier for those suffering from serious corneal diseases. Often in these circumstances, traditional cornea transplant is not a valid alternative. The number of artificial cornea transplant operations in the world has grown significantly every year since 2002, when new, more biocompatible and effective artificial cornea models became available. In particular, the Boston Artificial Cornea is increasingly used. In India, where corneal diseases are widespread, a production and development center for Artificial Cornea has been established in Boston. Here a new model of Artificial Cornea called Lucia was conceived.

When using the Artificial Cornea 

Artificial cornea transplant can be the ideal solution in cases of extensive corneal neovascularization as a consequence, for example, of herpetic keratitis, or corneal burn from acids or alkalis (e.g. lime or corrosive chemical agents) or stem cell deficiency. The main indication for performing an artificial cornea transplant today is the rejection of the traditional cornea transplant. When a natural cornea transplant is rejected it can be repeated, however the hopes that this transplant will survive are increasingly low. American statistics say that the first corneal transplant has 90% 5-year survival, the second corneal transplant has 50% 5-year survival and the third transplant has less than 20% 5-year survival. For this reason, after the second corneal transplant fails, today there is a tendency to have an artificial cornea transplant rather than proceed with further traditional corneal transplants. 

The Boston Artificial Cornea or Boston Keratoprosthesis 

There are different types of artificial cornea. The most used in the world is called Boston Artificial Cornea or Boston Keratoprosthesis, it was developed at Harvard University, Dr. Badalà was the first to implant it in Italy in 2008, to date he is the Italian surgeon with the most vast experience in the sector. The Boston Keratoprosthesis is made up as follows: there is a donor cornea on which an artificial cornea made of plastic and titanium is assembled. Once the artificial cornea is assembled with the donor cornea, the opaque patient cornea is removed and the new Boston Artificial Cornea complex is then sutured onto the patient’s eye. At this point a contact lens is applied. These patients will have to use contact lenses throughout their lives as well as specific eye drops. The advantage of this surgery is that it allows for extremely rapid visual recovery. Furthermore, should rejection occur, the artificial cornea, being made of plastic material, remains transparent and therefore there is no decline in vision as occurs with traditional cornea transplants when rejection occurs. 

Risks of the Artificial Cornea

Unfortunately, there are risks associated with the Boston Artificial Cornea. The most important risk is the risk of an infection: for this reason it is essential that the patient carefully follows the doctor’s instructions and undergoes regular checks at a cutting-edge centre.

Another associated risk is Glaucoma, which is often already present in these seriously ill eyes and which can worsen after the implantation of the Artificial Cornea, which is why careful monitoring of glaucoma in these patients is essential. In conclusion, today the Boston Keratoprosthesis is a valid solution for a whole series of patients for whom until yesterday we had no alternatives. All patients in whom corneal transplant is not indicated or has already failed today find hope from this innovative intervention. You can find in the testimonials section the stories of patients operated with the artificial cornea in Boston with the hope that this can help give hope to those suffering from serious corneal diseases. 

New Models of Artificial Cornea

Further types of artificial cornea are being studied, such as KeraKlear from the American company KeraMed, approved for clinical use in Europe but not in the USA where clinical trials are currently underway. Clinical experience with this artificial cornea is very limited and in any case the indications are different compared to the much more widespread Boston Artificial Cornea as the KeraKlear is an artificial cornea which is implanted using a lamellar and non-perforating transplant technique like the Boston keratoprosthesis.  Scientists at New Castle University in Britain have succeeded in engineering an artificial cornea using a 3D printer and stem cells derived from a donor human cornea. The study published a few years ago aroused great interest, however clinical trials on humans are still far away. The potential of an artificial cornea built in the laboratory using 3D printing techniques is very high however we are still waiting to understand how it can be tolerated in real clinical conditions. We will keep you updated.