The first keratoprosthesis implantation 1n 1955

Purpose to describe the Barcelona experience with the different types of keratoprosthesis for end-stage cicatricial corneal disease. Methods We present 6 cases showing various types of keratoprosthesis which we have used at the Barraquer Eye Center from the 1950´s up to the present. Results We describe the first keratoprosthesis ever implanted in Spain, on a case of severe chemical burn on a young lady. We implanted a Dorzee acrylic keratoprosthesis in 1955. 5 years later she had extrusion of the prosthesis and superior retinal detachment. The second case describes the Dorzee-Barraquer-Cardona acrylic implant implanted in 1958 on a patient with end-stage glaucoma. Patient had good anatomical retention until his death in 1970. The third case describes the use of the Cardona keratoprosthesis in 1960. Patient had good anatomical and functional results for 8 years until suffering from an acute endophthalmitis. The fourth case demonstrates the expulsion of a Teflon-supported keratoprosthesis designed by Girard. The fifth case describes the first implantation of an osteo-odontokeratoprosthesis designed by Strampelli on a blast injury showing good results for 10 years. The last case shows our experience on the Boston keratoprosthesis which we started using in 2006. Finally, we present our technique of the osteo-odontokeratoprosthesis and a summary of our clinical results from 1970´s to the present. Conclusion Our clinical experience for more than 50 years on the use of keratoprosthesis shows that while the surgical technique, design and post-operative treatment of both biological and non-biological keratoprosthesis have improved thru the years, the anatomical and functional success remains a challenge for the KPro surgeon.