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Abstract：
OBJECTIVE: To evaluate the outcome and complications after implantation of the Boston type I keratoprosthesis (Kpro) in two groups of eyes.
METHODS: We retrospectively reviewed records of 28 eyes with failed Penetrating keratoplasty (PKP) (Group A) and 31 eyes with severe ocular surface diseases who implanted Kpro. Follow-up was performed for a mean 37 months. Primary outcomes were Kpro retention and visual improvement, secondary outcomes included the occurrence of complications as endophthalmitis, retro-prosthesis membrane (RPM), intraocular pressure (IOP) abnormalities, posterior capsule opacification (PCO), graft thinning and extrusion.
RESULTS: Visual improvement was achieved in 20 eyes in Group A, and in 19 eyes in Group B. In group A, the prosthesis was retained in 25 eyes, while prosthesis retention in Group B was in 26 eyes. Group A had higher rates of PCO, high IOP, soft IOP, and graft thinning. Group B had higher risk of RPM, and endophthalmitis. Two eyes in Group A, and Five eyes in Group B required redo procedure.
CONCLUSIONS: The Boston Kpro type I is an effective procedure in eyes with high risk of keratoplasty failure and in severe ocular surface diseases, it has a high retention rate, higher in cases following failed PKP.
METHODS: We retrospectively reviewed records of 28 eyes with failed Penetrating keratoplasty (PKP) (Group A) and 31 eyes with severe ocular surface diseases who implanted Kpro. Follow-up was performed for a mean 37 months. Primary outcomes were Kpro retention and visual improvement, secondary outcomes included the occurrence of complications as endophthalmitis, retro-prosthesis membrane (RPM), intraocular pressure (IOP) abnormalities, posterior capsule opacification (PCO), graft thinning and extrusion.
RESULTS: Visual improvement was achieved in 20 eyes in Group A, and in 19 eyes in Group B. In group A, the prosthesis was retained in 25 eyes, while prosthesis retention in Group B was in 26 eyes. Group A had higher rates of PCO, high IOP, soft IOP, and graft thinning. Group B had higher risk of RPM, and endophthalmitis. Two eyes in Group A, and Five eyes in Group B required redo procedure.
CONCLUSIONS: The Boston Kpro type I is an effective procedure in eyes with high risk of keratoplasty failure and in severe ocular surface diseases, it has a high retention rate, higher in cases following failed PKP.
摘要：
目的：评估两组眼植入BostonI型人工角膜（Kpro）后的结果和并发症。
方法：我们回顾性回顾了28只眼穿透性角膜移植术（PKP）失败的记录（A组）和31只眼植入Kpro的严重眼表疾病的记录。随访平均37个月。主要结果是Kpro保留和视觉改善，次要结局包括眼内炎等并发症的发生,后假体膜（RPM），眼内压（IOP）异常，后囊混浊（PCO），移植物变薄和挤压。
结果：A组20只眼视力得到改善，B组19只眼A组,假体保留在25只眼睛中，而B组的假体保留率为26只眼。A组PCO率较高，高IOP,软IOP，和移植物变薄。B组发生RPM的风险较高，和眼内炎。A组两只眼睛,B组5只眼需要重做手术。
结论：对于角膜移植术失败的高风险和严重的眼表疾病，波士顿KproI型是一种有效的手术，它有很高的保留率，PKP失败后的病例更高。
方法：我们回顾性回顾了28只眼穿透性角膜移植术（PKP）失败的记录（A组）和31只眼植入Kpro的严重眼表疾病的记录。随访平均37个月。主要结果是Kpro保留和视觉改善，次要结局包括眼内炎等并发症的发生,后假体膜（RPM），眼内压（IOP）异常，后囊混浊（PCO），移植物变薄和挤压。
结果：A组20只眼视力得到改善，B组19只眼A组,假体保留在25只眼睛中，而B组的假体保留率为26只眼。A组PCO率较高，高IOP,软IOP，和移植物变薄。B组发生RPM的风险较高，和眼内炎。A组两只眼睛,B组5只眼需要重做手术。
结论：对于角膜移植术失败的高风险和严重的眼表疾病，波士顿KproI型是一种有效的手术，它有很高的保留率，PKP失败后的病例更高。
