PDF(Pubmed)
Abstract：
Type I Boston keratoprosthesis is implanted in patients with severely diseased eyes who are considered poor candidates for traditional keratoplasty. Glaucoma is considered a major visual comorbidity following the implantation of type I Boston keratoprosthesis (KPro). Eyes that receive a Boston KPro are at high risk of progression of pre-existing glaucoma and the development of de novo glaucoma. Both complications can limit best-corrected visual acuity postoperatively. Diagnosis and surveillance for glaucoma in KPro eyes are fundamental to mitigate the risk of visual morbidity. However, managing these patients presents several challenges. The diagnosis of glaucoma after KPro implantation is usually hindered by inaccurate intraocular pressure (IOP) measurements and unreliable ophthalmic investigations such as visual field testing and optical coherence tomography (OCT) of the retinal nerve fiber layer (RNFL). In these eyes, medical management of glaucoma with topical medications is usually insufficient, and glaucoma surgery is usually warranted either prior to or during KPro implantation. Options for glaucoma surgery include glaucoma drainage device (GDD) and cyclodestructive procedures. The aim of this article is to highlight the incidence, pathophysiology, diagnosis, and management options of glaucoma in eyes that have undergone type I Boston keratoprosthesis.
摘要：
I型波士顿人工角膜被植入患有严重疾病的眼睛的患者中，这些患者被认为是传统角膜移植术的不良候选人。青光眼被认为是植入I型波士顿人工角膜（KPro）后的主要视觉合并症。接受波士顿KPro的眼睛处于先前存在的青光眼进展和从头青光眼发展的高风险中。两种并发症都会限制术后最佳矫正视力。KPro眼青光眼的诊断和监测是降低视力发病风险的基础。然而,管理这些患者提出了一些挑战。KPro植入后青光眼的诊断通常受到不准确的眼内压（IOP）测量和不可靠的眼科检查的阻碍，例如视野测试和视网膜神经纤维层（RNFL）的光学相干断层扫描（OCT）。在这些眼睛里,用局部药物治疗青光眼通常是不够的，和青光眼手术通常需要在KPro植入之前或期间进行。青光眼手术的选择包括青光眼引流装置（GDD）和循环破坏程序。本文的目的是强调发病率，病理生理学,诊断,以及接受波士顿Ⅰ型人工角膜手术的青光眼的治疗选择。
