From the Guidelines
Coreoplasty is indicated for the treatment of severe corneal edema and opacification, particularly in cases where other forms of corneal transplantation are not suitable, as evidenced by the use of the Boston keratoprosthesis (BKPro) in patients with multiple corneal transplant failures, ocular trauma, and other conditions 1. The main indications for coreoplasty include:
- Severe bilateral corneal blindness due to multiple corneal transplant failures
- Ocular trauma
- Herpetic keratitis
- Aniridia
- Stevens-Johnson syndrome
- Limbal stem cell deficiency
- Silicone oil filled eyes
- Neurotrophic keratopathy
- Extensive corneal neovascularization The procedure aims to restore vision and improve quality of life in patients with severe corneal edema and opacification, with visual acuity improving to 20/200 or better in 50% to 65% of patients at 3 years of follow-up 1. The decision to perform coreoplasty should be based on the severity of symptoms, the underlying cause of the corneal edema and opacification, and the potential for visual improvement, as well as the presence of ocular comorbidities that may affect the retention rate of the BKPro 1. It is essential to note that coreoplasty is a complex procedure that requires a multispecialty approach, including glaucoma and retina specialists, and lifelong antimicrobial prophylaxis is recommended to prevent vision-threatening endophthalmitis 1.
From the Research
Coreoplasty Indication
- The provided studies do not directly mention coreoplasty, but they discuss frontalis sling surgery and its indications for ptosis with poor levator function 2, 3, 4, 5, 6.
- Frontalis sling surgery is often used to treat congenital ptosis with poor levator function, as it creates a linkage between the frontalis muscle and the tarsus, allowing the frontalis muscle to elevate the eyelid 2, 3.
- The studies suggest that frontalis sling surgery can be effective in treating ptosis with poor levator function, with good to excellent functional and cosmetic results achieved in many patients 3, 5, 6.
- However, the optimal material for frontalis sling surgery is unknown, and different materials such as polytetrafluoroethylene, Ethibond suture, Mersilene mesh, and autogenous fascia lata have been used with varying success rates 4.
- Complications of frontalis sling surgery can include eyelid lag, lagophthalmos, undercorrection, suture granuloma, sling exposure, and late recurrence of ptosis 3, 6.