The Boston keratoprosthesis.
The Boston keratoprosthesis.
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DOI：
10.1097/iio.0b013e3181e20cca
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发表时间：
2010-01-01
影响因子：
--
通讯作者：
Colby, Kathryn A
中科院分区：
文献类型：
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作者：
Klufas, Michael A;Colby, Kathryn A
穿透性角膜移植术（PKP）是大多数需要手术治疗的角膜疾病的标准治疗方法，1并且通常具有良好的成功率。然而，包括复发性移植失败、2例先天性角膜混浊3和眼烧伤4，5在内的某些情况下，标准PKP的预后较差。人工角膜或人工角膜（KPro）是这些人群角膜盲的可行治疗选择。17896年首次提出使用KPro来恢复视力，第一次KPro手术于1855年进行。8在过去的几十年中，已经描述了许多KPro设备，其中大多数分为两类：具有领扣设计的设备和具有芯部和裙部设计的设备。波士顿KPro是一种领扣装置，于1992年首次获得FDA批准上市。设计和术后管理的改进导致该器械的使用急剧增加。2002年，进行的手术不到50例，而2009年为1 161例（图1）。到目前为止，全世界已经进行了3500多例手术。9最近的一项研究表明，波士顿KPro在成本效益和质量调整寿命年方面与PKP相当。10 Boston KPro远未达到完美;然而，鉴于该器械的最新结果，将人工角膜手术视为最后手段的观点是不合时宜的。本文将回顾波士顿KPro的现状，包括设计创新，www.国际眼科学网| 161
Penetrating Keratoplasty (PKP) is the standard treatment for most corneal diseases that require surgical management, 1 and in general, has a good rate of success. However, certain conditions including recurrent graft failure, 2 congenital corneal opacifications, 3 and ocular burns4, 5 have a poor prognosis with standard PKP. An artificial cornea or keratoprosthesis (KPro) is a viable treatment option for cornea blindness in these populations. The use of a KPro to restore vision was first suggested in 17896, 7 and the first KPro surgery was carried out in 1855. 8 Over the earlier decades, numerous KPro devices have been described, most of which fall into 2 categories: those with a collar button design and those with a core and skirt design. The Boston KPro, a collar button device, was first cleared for marketing by the FDA in 1992. Improvements in design and postoperative management have led to a dramatic increase in the usage of this device. In 2002, fewer than 50 procedures were carried out compared with 1161 cases in 2009 (Fig. 1). To date, more than 3500 procedures have been carried out worldwide. 9 A recent study suggests the Boston KPro is comparable with PKP in terms of cost effectiveness and quality-adjusted life years. 10 The Boston KPro is far from perfected; however, the view of keratoprosthesis surgery as a procedure of last resort is anachronistic in light of recent results with this device. This article will review the current state of the Boston KPro including innovations in design, www. internat-ophthalmology. com| 161