The Boston Keratoprosthesis Type II: The Massachusetts Eye and Ear Infirmary Experience
The Boston Keratoprosthesis Type II: The Massachusetts Eye and Ear Infirmary Experience
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DOI：
10.1097/ico.0b013e318215207c
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发表时间：
2011-12-01
期刊：
影响因子：
2.8
通讯作者：
Chodosh, James
中科院分区：
文献类型：
--
作者：
Pujari, Siddharth;Siddique, Sana S.;Chodosh, James
目的：通过回顾性干预性病例系列研究，报告Boston人工角膜II型植入治疗严重眼表疾病和角膜盲的长期结局：本回顾性研究包括2000年1月1日至2009年12月31日在马萨诸塞州眼耳医院接受Boston人工角膜II型植入的患者的病历。分析的主要结果指标是视力，人工角膜保留，和术后并发症。结果：共29眼的26例患者在研究期间接受了波士顿人工角膜II型。手术患者因粘膜类天疱疮（51.7%）、Stevens-Johnson综合征/中毒性表皮坏死松解症（41.4%）或其他眼表疾病（6.9%）导致角膜盲。术后视力≥ 20/200者23眼（79.3%），≥ 20/30者10眼（34.5%）。在至少随访1年的患者中（n = 21），12只眼（57.1%）的视力保持在20/200或更好。随访5年以上的13只眼中，6只眼（46.2%）末次随访时视力≥ 20/200。在随访期间未改善至20/200或丧失视力的眼睛患有终末期青光眼、先前的视网膜脱离或年龄相关性黄斑变性。在总共29只眼睛中，17个设备（58.6%）被保留，没有挤出或更换在107.9 person-year.Conclusions的总随访时间：波士顿人工角膜II型是一个可行的选择角膜失明严重的自身免疫性眼表疾病。
Purpose: To report the long-term outcomes of Boston keratoprosthesis type II implantation in the management of severe ocular surface disease and corneal blindness through a retrospective interventional case series.Methods: This retrospective review included medical records of patients who underwent Boston keratoprosthesis type II implantation at the Massachusetts Eye and Ear Infirmary from January 1, 2000 through December 31, 2009. The main outcome measures analyzed were visual acuity, keratoprosthesis retention, and postoperative complications.Results: A total of 29 eyes of 26 patients received a Boston keratoprosthesis type II during the study period. Patients undergoing operation had corneal blindness because of mucous membrane pemphigoid (51.7%), Stevens-Johnson syndrome/toxic epidermal necrolysis (41.4%), or other ocular surface disease (6.9%). Visual acuity after surgery improved to 20/200 or better in 23 eyes (79.3%) and to 20/30 or better in 10 eyes (34.5%). In patients with at least 1 year of follow-up (n = 21), visual acuity of 20/200 or better was maintained in 12 eyes (57.1%). Of 13 eyes followed-up for more than 5 years, 6 eyes (46.2%) had visual acuity of 20/200 or better at the last follow-up examination. Eyes that did not improve to 20/200 or lost vision during the follow-up had end-stage glaucoma, previous retinal detachment, or age-related macular degeneration. Of the total of 29 eyes, 17 devices (58.6%) were retained without extrusion or replacement during a total follow-up time of 107.9 person-years.Conclusions: The Boston keratoprosthesis type II is a viable option for corneal blindness from severe autoimmune ocular surface diseases.