Artificial corneas versus donor corneas for repeat corneal transplants
Identifieur interne : 001702 ( Pmc/Corpus ); précédent : 001701; suivant : 001703Artificial corneas versus donor corneas for repeat corneal transplants
Auteurs : Esen K. Akpek ; Majed Alkharashi ; Frank S. Hwang ; Sueko M. Ng ; Kristina LindsleySource :
- The Cochrane database of systematic reviews [ 1469-493X ] ; 2014.
Abstract
Individuals who have failed one or more full thickness penetrating keratoplasties (PKs) may be offered repeat corneal surgery using an artificial or donor cornea. An artificial or prosthetic cornea is known as a keratoprosthesis. Both donor and artificial corneal transplantations involve removal of the diseased and opaque recipient cornea (or the previously failed cornea) and replacement with another donor or prosthetic cornea.
To assess the effectiveness of artificial versus donor corneas in individuals who have had one or more failed donor corneal transplantations.
We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2013, Issue 10), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to November 2013), EMBASE (January 1980 to November 2013), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to November 2013), the
Two review authors independently assessed reports from the electronic searches to identify randomized controlled trials (RCTs) or controlled clinical trials (CCTs). We resolved discrepancies by discussion or consultation with a third review author.
For discussion purposes, we assessed findings from observational cohort studies and non-comparative case series. No data synthesis was performed.
We did not identify any RCTs or CCTs comparing artificial corneas with donor corneas for repeat corneal transplantations.
The optimal management for those individuals who have failed a conventional corneal transplantation is not known. Currently, in some centers, artificial corneal devices routinely are recommended after just one graft failure, and in others, not until after multiple graft failures, or not at all. To date, there have been no controlled trials comparing the visual outcomes and complications of artificial corneal devices (particularly the Boston type 1 keratoprosthesis which is the most commonly implanted artificial corneal device) with repeat donor corneal transplantation, in order to guide surgeons and their patients. It is apparent that such a trial is needed and would offer significant benefit to an ever-increasing pool of people with visual disability due to corneal opacification, most of whom are still in productive stages of their lives.
Url:
DOI: 10.1002/14651858.CD009561.pub2
PubMed: 25372407
PubMed Central: 4270365
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