Keratoprosthesis: The Dohlman-Doane device
Keratoprosthesis: The Dohlman-Doane device
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DOI：
10.1016/j.ajo.2005.06.041
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发表时间：
2005-12-01
影响因子：
4.2
通讯作者：
Palakuru, JR
中科院分区：
文献类型：
--
作者：
Aquavella, JV;Qian, Y;Palakuru, JR
目的：探讨Dohlman-Doane I型角膜假体在传统穿透性角膜移植术预后不良的患者视力康复中的应用价值。设计：回顾性、非比较性介入研究，纳入25例持续多次移植失败或其他方面认为不适合常规角膜移植术的患者。方法：评估候选人的潜在敏锐度、眼压、炎症、眼表质量和穿透性角膜移植术的总体预后。将角膜假体组装并安装在直径8.5或9.0 mm的供体角膜按钮上，并用12至16条9-0尼龙缝合线将其缝合到直径8.0或8.5 mm的受体床上。患者在第一天，随后在1周和1个月，然后每隔3个月检查一次。结果：所有器械均保留，无脱位或挤压。无眼内炎或眼表感染病例。术后第一天眼底细节可见。患者平均2个月（1 ~ 180天）达到最佳视力。平均13天（1至60天）观察到视力改善。3例发生假体后膜，1例多发复发。视力范围从无光感到20/25。结论：在预后不良的角膜移植术中，该假体可常规植入并维持，并发症少，具有恢复视力的潜力。
PURPOSE: To determine the usefulness of the Dohlman-Doane type I keratoprosthesis for visual rehabilitation in cases of poor prognosis for traditional penetrating keratoplasty.DESIGN: A retrospective, noncomparative interventional series of 25 patients who had sustained multiple graft failure or who were otherwise deemed poor candidates for conventional keratoplasty.METHODS: Candidates were evaluated for potential acuity, intraocular pressure, inflammation, the quality of the ocular surface, and overall prognosis for penetrating keratoplasty. The keratoprosthesis was assembled and mounted on an 8.5, or 9.0-mm diameter donor corneal button and sutured into an 8.0, or 8.5-mm diameter recipient bed with 12 to 16 9-0 nylon sutures. Patients were examined on the first day and subsequently in 1 week and 1 month and then at 3-month intervals.RESULTS: All devices were retained without dislocation or extrusion. There were no instances of endophthalmitis or surface infection. Fundus details were visible on the first postoperative day. Patients achieved their best acuity in an average of 2 months (range, 1 to 180 days). Improvement in acuity was observed in an average of 13 days (range, 1 to 60 days). Retroprosthetic membranes occurred in three cases, with multiple recurrences in one instance. Visual acuity ranged from no light perception to 20/25.CONCLUSION: We conclude that this prosthesis can be implanted routinely and maintained with minimal complications in poor prognosis keratoplasty, which presents the potential for visual rehabilitation.