Retroprosthetic membranes in AlphaCor patients - Risk factors and prevention
Retroprosthetic membranes in AlphaCor patients - Risk factors and prevention
复制标题
DOI：
10.1097/01.ico.0000154380.13237.ea
复制
发表时间：
2005-08-01
期刊：
影响因子：
2.8
通讯作者：
Hamilton, S
中科院分区：
文献类型：
--
作者：
Hicks, CR;Hamilton, S
目的：报告与AlphaCor相关的假体后膜(RPM)的形成，确定其形成的危险因素和预防和处理策略。方法：回顾AlphaCor的资料、病历和文献复习。结果：14例(9.3%)RPM与AlphaCor有关。我们发现与全身性危险因素(种族、高血压、糖尿病)显著相关，而不是眼科病史，但围手术期处理也可能与RPM的发展风险有关。组织学显示有纤维血管组织，类似于疤痕角膜组织。其他装置也有类似的组织学发现。结论：有早期人工角膜的角膜后膜和RPM经常被报道，但没有特定的可识别的原因。众所周知，糖尿病与眼内膜的形成有关。这项研究表明，系统性因素影响AlphaCor形成RPM的风险。在被确定为有较高的膜形成风险的病例中，应考虑围手术期和术后的治疗，如类固醇、非类固醇类药物、肝素或RTPA。在我们的系列中，几种治疗和手术策略似乎是有效的，但术前识别风险增加的患者并在必要时采取预防措施可能是将这种并发症的发生率降至最低的关键。
Purpose: To report retroprosthetic membrane (RPM) formation in association with AlphaCor and identify risk factors for their formation and strategies for prevention and management.Methods: Review of AlphaCor data and case histories and literature review.Results: RPMs occurred with AlphaCor in 14 (9.3%) cases. We find significant associations with systemic risk factors (race, hypertension, diabetes mellitus) rather than ocular history, but perioperative management may also be related to risk of RPM development. Histology demonstrates a fibrovascular tissue resembling scarred corneal tissue. Similar histologic findings have been reported for other devices.Conclusion: Retrocorneal membranes and RPMs with earlier keratoprostheses have frequently been reported without specific identifiable causes. Diabetes is known to be associated with intraocular membrane formation. This study demonstrates that systemic factors affect the risk of RPM formation with AlphaCor. In cases identified as at greater risk of membrane formation, peri- and postoperative therapies such as steroids, non-steroidals, heparin or rTPA should be considered. In our series, several therapeutic and surgical strategies appear effective but recognizing patients at increased risk preoperatively and using preventive measures where indicated is likely to be key to minimizing the incidence of this complication.