New alternative for restoring vision in cases of irreversible corneal opacification

02/07/2026

Some diseases, such as autoimmune disorders (e.g. Stevens-Johnson syndrome or pemphigoid) and alterations caused by chemical burns, can seriously damage the ocular surface, irreversibly opacifying the cornea and causing severe vision loss. In these cases, corneal transplantation may be an option, but when there is a high risk of rejection, a corneal prosthesis or keratoprosthesis is used. The most widely used worldwide is the Boston type 1, which consists of a transparent optical cylinder assembled in a donor cornea and fixed with a titanium back plate.

At the Barraquer Ophthalmology Centre, we have developed an innovative technique that combines the Boston type 1 keratoprosthesis with an autologous buccal mucosa covering. The novelty consists of covering the ocular surface with a sheet of mucosa taken from the patient’s own lower lip, leaving an opening through which the patient can see. The mucosa helps maintain ocular hydration and provides antimicrobial and growth factors, while also offering protection against necrosis. Its rich vascularisation and resistance facilitate tissue adhesion, epithelial regeneration and biointegration with the ocular surface, which could reduce the rate of prosthesis extrusion and avoid replacement surgery.

Our results in 19 patients, published in the American Journal of Ophthalmology, show an anatomical retention rate of 89% in the first year and an improvement in vision in 92% of cases. Although complications related to the mucosa may arise, most are treatable, making this technique a very promising new alternative for cases with moderate to severe ocular surface damage.

Mònica Martí Orpinell, clinical research coordinator