This technology allows for surgical repair of eyes that might otherwise be irreparably damaged by combined anterior and posterior segment trauma. The corneal wound, if not previously repaired, is sutured close. A 360 degree conjunctival peritomy may be performed at the limbus. The four rectus muscles may be isolated for stabilization of the eye. A Flieringa ring can be sutured to the sclera to prevent collapse of the globe, particularly in children.
Infusion permits control of the intraocular pressure throughout the procedure.
Typically, a trephine 0.25mm smaller than the diameter of the central peg of the temporary keratoprosthesis is used. However, with the new, wide angle PMMA temporary keratoprosthesis, it is no longer mandatory that a water-tight fit be obtained between the central peg of the keratoprosthesis and the corneal stroma. The actual seal between the intraocular contents and the atmosphere is located between the under surface of the keratoprosthesis flange and the anterior surface of the host cornea. This is particularly true when strong fixation sutures are used such as 5-0 mersilene. Partial trephinization of the corneal button is performed with a hand-held trephine.