PDF(Pubmed)
Abstract：
Background: Boston Keratoprosthesis Type I (BI-KPro I) is a synthetic cornea that can be used to restore vision in patients with corneal blindness. This retrospective study evaluated the outcomes of BI-KPro implantation in 118 patients. Material: The mean age of the patients was 56.76 ± 14.24 years. Indications for keratoprosthesis implantation were as follows: graft failure, 47 (39.83%); ocular burn, 38 (32.20%); neurotrophic keratopathy, 11 (9.32%), mucous membrane pemphigoid 9 (7.67%); autoimmune, 6 (5.08%); Stevens-Johnson syndrome, 4 (3.39%); and aniridia (2.54%). Methods: The surgeries were performed between March 2019 and June 2022 at a single clinical center in two locations. The postoperative visual acuity, complications, and need for additional surgical procedures were analyzed. Results: The Best Corrected Visual Acuity before surgery was 0.01 ± 0.006. After one year (V1), it was 0.30 ± 0.27; at two years (V2), it was 0.27 ± 0.26; and at three years (V3), it was 0.21 ± 0.23. The percentage of patients with visual acuity better than 0.1 on the Snellen chart was 37.29% after 1 year, 49.35% after 2 years, and 46.81% after 3 years of follow up. The most common complications were glaucoma (78 patients; 66.1%), corneal melting (22 patients; 18.6%), and retroprosthetic membranes (20 patients; 17.0%). Conclusions: The BI-KPro can significantly improve visual acuity. The worst long-term results were obtained in the group of patients with autoimmune diseases; therefore, careful consideration should be given to implanting BI-KPro in this group. The high incidence of de novo glaucoma or the progression of pre-existing glaucoma suggests the need for careful monitoring.
摘要：
背景：波士顿人工角膜I型（BI-KProI）是一种合成角膜，可用于恢复角膜盲患者的视力。这项回顾性研究评估了118例患者BI-KPro植入的结果。材料：患者的平均年龄为56.76±14.24岁。角膜假体植入的适应症如下：移植失败，47（39.83%）;眼烧伤，38（32.20%）；神经营养性角膜病变，11（9.32%），粘膜类天疱疮9（7.67％）;自身免疫，6（5.08%）；史蒂文斯-约翰逊综合征，4（3.39%）；无虹膜（2.54%）。方法：手术于2019年3月至2022年6月在两个地点的单个临床中心进行。术后视力,并发症,并分析了是否需要额外的外科手术。结果：术前最佳矫正视力为0.01±0.006。一年后（V1），为0.30±0.27；在两年(V2)时，为0.27±0.26；在三年(V3)时，它是0.21±0.23。1年后Snellen图上视力优于0.1的患者比例为37.29%,2年后49.35%，随访3年后为46.81%。最常见的并发症是青光眼（78例；66.1%），角膜融化（22例；18.6%），和后假体膜（20例；17.0％）。结论:BI-KPro能显著提高视力。在患有自身免疫性疾病的患者组中获得了最差的长期结果；因此，应仔细考虑在该组中植入BI-KPro。从头青光眼的高发病率或先前存在的青光眼的进展表明需要仔细监测。
