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Eighteen years' experience with the Girard keratoprosthesis has shown that keratoprosthesis can be successful in visual rehabilitation of otherwise blind individuals. It is indicated in eyes which cannot be rehabilitated by human keratoplasty, i.e., chemical burns, Stevens-Johnson syndrome, ocular pemphigoid, severe anterior cleavage syndrome, certain injuries, and multiple graft failures. Visual results can be excellent initially but long-term follow-up shows a gradual decay in vision due to complications, i.e., conjunctival retraction, leakage, uveitis, glaucoma, retinal detachment, epithelial downgrowth, or endophthalmitis.

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