评估MICOF人工角膜治疗终末期角膜盲的长期解剖和功能结果。
连续临床病例系列的回顾性回顾。
2000年10月至2015年10月,中国人民解放军总医院眼科,131例患者中的132只眼接受了MICOF人工角膜植入术.其中,90例患者的91只眼纳入本研究。
术前信息,外科手术,收集每只纳入眼的术后数据。
最佳矫正视力(BCVA),角膜假体保留,并报告了严重的术后并发症。
手术最常见的适应症是化学烧伤或热烧伤(68.1%,91只眼中的62只眼)和爆炸伤害(12.1%,91只眼睛中的11只)其次是史蒂文斯-约翰逊综合症(10.0%,91只眼睛中的9只),干燥综合征(4.4%,91只眼睛中的4只)粘膜类天疱疮(3.3%,91只眼中的3只眼)和多穿透性角膜移植术失败(2.2%,91只眼睛中的2只)。平均随访时间为8.38±3.22年(范围:5-17.25年,中位数:7.67年)。所有患者的术前视力均为手部运动或更差。MICOF角膜假体可显着改善双侧终末期角膜盲患者的视觉功能。术后视力改善至20/200或更好的41眼(45.1%,91只眼)和最后一次随访时32只眼(91只眼的35.2%)的20/100或更好。先前存在的青光眼有17只(91只眼中的18.7%)。术后最常见的并发症是表面粘膜过度生长(31.9%,91只眼睛中的29只),青光眼(25.3%,91只眼睛中的23只)后假体膜(15.4%,91只眼睛中的14只),人工角膜装置挤压(15.4%,91只眼睛中的14只),浅表组织变薄(14.3%,91只眼睛中的13只),眼内炎(13.2%,91只眼睛中的12只),钛框架暴露(13.2%,91只眼睛中的12只),光学圆柱体前位移(13.2%,91只眼睛中的12只),角膜融化(7.7%,91只眼睛中的7只),视网膜脱离(6.6%,91只眼中的6只眼)和房水渗漏(2.2%,91只眼睛中的2只)。84.6%(91只眼中的77只眼)的眼睛在最新随访时保留了最初的角膜假体。
MICOF角膜假体是挽救终末期角膜盲症患者视力的可靠方法,并且比BostonKproⅡ型更好。
To evaluate long-term anatomical and functional outcomes of the MICOF keratoprosthesis to treat end-stage corneal blindness.
Retrospective review of consecutive clinical case series.
Between October 2000 and October 2015, at the Department of Ophthalmology of Chinese PLA General Hospital (PLAGH), a total of 132 eyes of 131 patients had undergone a MICOF keratoprosthesis implantation. Of those, 91 eyes of 90 patients were included in this study.
Preoperative information, surgical procedures, and postoperative data were collected for each included eye.
Best-corrected visual acuity (BCVA), keratoprosthesis retention, and significant postoperative complications were reported.
The most common indications for surgery were chemical or thermal burns (68.1%, 62 of 91 eyes) and explosive injury (12.1%, 11 of 91 eyes), followed by Stevens-Johnson Syndrome (10.0%, 9 of 91 eyes), Sjögren\'s syndrome (4.4%, 4 of 91 eyes), mucous membrane pemphigoid (3.3%, 3 of 91 eyes) and multi-penetrating keratoplasty failure (2.2%, 2 of 91 eyes). The mean follow-up duration was 8.38 ± 3.22 years (range: 5-17.25 years, median: 7.67 years). All patbients had a preoperative visual acuity of hand motions or worse. A MICOF keratoprosthesis significantly improved patients\' visual function with bilateral end-stage corneal blindness. Postoperative visual acuity improved to 20/200 or better in 41 eyes (45.1%, of 91 eyes) and to 20/100 or better in 32 eyes (35.2% of 91 eyes) at the last follow-up visit. Preexisting glaucoma was present in 17 (18.7% of 91 eyes). The most common postoperative complications were overgrowth of the surface mucosa (31.9%, 29 of 91 eyes), glaucoma (25.3%, 23 of 91 eyes), retro-prosthetic membrane (15.4%, 14 of 91 eyes), keratoprosthesis device extrusion (15.4%, 14 of 91 eyes), superficial tissue thinning (14.3%, 13 of 91 eyes), endophthalmitis (13.2%, 12 of 91 eyes), titanium frame exposure (13.2%, 12 of 91 eyes), optical cylinder ante-displacement (13.2%, 12 of 91 eyes), cornea melting (7.7%, 7 of 91 eyes), retinal detachment (6.6%, 6 of 91 eyes) and aqueous humour leakage (2.2%, 2 of 91 eyes). 84.6% (77 of 91 eyes) of the eyes retained their initial keratoprosthesis at the latest follow-up.
A MICOF keratoprosthesis is a reliable approach to rescue vision in end-stage corneal blinded patients and has better retention than a Boston Kpro TypeⅡ.