History of the Artificial Cornea

The concept of an artificial cornea for transplantation predates work with corneal tissue transplants. Guillaume Pellier de Quengsy described the first known design for a keratoprosthesis in 1789. In his original paper, he asks the question, “would it not

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History of the Artificial Cornea Samuel H. Lee, M. Soledad Cortina, and Jose de la Cruz

Contents References .................................................................

S.H. Lee, MD Department of Ophthalmology and Visual Sciences, Cornea and Refractive Surgery Service, Illinois Eye and Ear Infirmary, University of Illinois School of Medicine, 1855 W Taylor Street, Chicago, IL 60612, USA e-mail: [email protected] M.S. Cortina, MD Cornea, External Disease and Refractive Surgery Service, Artificial Cornea Program, Illinois Eye and Ear Infirmary, Department of Ophthalmology and Visual Sciences, University of Illinois School of Medicine, 1855 West Taylor Street, Chicago, IL 60612, USA e-mail: [email protected] J. de la Cruz, MD (*) Cornea, External Disease and Refractive Surgery Service, Millennium Park Eye Center, Illinois Eye and Ear Infirmary, Department of Ophthalmology and Visual Sciences, University of Illinois School of Medicine, 30 N. Michigan Avenue Suite 410, Chicago, IL 60602, USA e-mail: [email protected]

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The concept of an artificial cornea for transplantation predates work with corneal tissue transplants. Guillaume Pellier de Quengsy described the first known design for a keratoprosthesis in 1789. In his original paper, he asks the question, “would it not be possible to implant an artificial cornea instead of the natural one when one is certain that the loss of vision comes from the opacity of this tunic? This will be easy to verify. Here is the operation one could attempt… Use a clear, thin piece of glass… convex outside, with the diameter of the cornea, place it inside a small circle of silver… Around the exterior circle, have a groove made proportional to the thickness of the natural cornea so that the sclera can exactly adapt to it by secreting new juices….” He goes on to describe the surgery in detail, outlining the importance of operating on a “clear day” with plenty of sunlight, performing the surgery with an assistant holding the lids open while the patient is supine on a bed. Despite the confident promotion of his technique, Pellier de Quengsy had yet to perform it. It is believed that his brother, Denis, also an oculist, was the first to attempt the described procedure around that time, and then there is mention of a single patient in 1802 that underwent keratoprosthetic transplantation with Pellier using this technique, but the details are hazy [1, 2]. Later in the 1800s, other approaches were considered mainly by Johann Nepomuk von Nussbaum, Adolf Weber, Arthur von Hippel, and Friedrich Dimmer.

M. Soledad Cortina, J. de la Cruz (eds.), Keratoprostheses and Artificial Corneas: Fundamentals and Surgical Applications, DOI 10.1007/978-3-642-55179-6_2, © Springer-Verlag Berlin Heidelberg 2015

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S.H. Lee et al.

14 Fig. 2.1 Nussbaum’s keratoprosthesis (From Mannis and Dohlman [12])

Nussbaum’s prosthesis design was made of glass in the form of a double stem with anterior and posterior flanges (Fig. 2.1). Nussbaum himself experimented with the biocompatibility of different materials