Glaucoma in Eyes With Severe Chemical Burn, Before and After Keratoprosthesis
Glaucoma in Eyes With Severe Chemical Burn, Before and After Keratoprosthesis
复制标题
DOI：
10.1097/ico.0b013e31821eead6
复制
发表时间：
2011-12-01
期刊：
影响因子：
2.8
通讯作者：
Dohlman, Claes H.
中科院分区：
文献类型：
--
作者：
Cade, Fabiano;Grosskreutz, Cynthia L.;Dohlman, Claes H.
目的：本研究的目的是评估青光眼的发病率与严重的化学烧伤的眼睛，之前和之后的人工角膜。方法：回顾性图表审查23例严重的眼部化学烧伤谁经历了波士顿人工角膜（BKPro）手术在马萨诸塞州眼耳医院，在1990年和2010年之间。回顾了术前和术后青光眼的发生率和严重程度。相关问题，如化学烧伤的类型;视力（VA）;设备留存率;数量和性质的先前，伴随，和随后的程序;和其他术后并发症的发生率，进行了审查，平均随访时间为57 months.Results：有术前病史或青光眼体征的眼睛的数量为21，其中9个青光眼进展后BKPro植入。此外，2只眼术后发生青光眼。所有患眼术前视力均为数指或更差。最佳矫正的术后视力范围为无光感至20/20。17只眼（61%）在随访期间的某个时间点达到20/60或更好的VA，但只有9只眼（32%）在末次随访时保持20/60。在28只眼中，6只更换了1次BKPro，1只更换了2次。结论：青光眼在严重化学烧伤的眼睛中很常见。人工角膜可以恢复视力，但术后青光眼可能难以管理。
Purpose: The purpose of this study was to evaluate the incidence of glaucoma in eyes with severe chemical burn, before and after keratoprosthesis.Methods: A retrospective chart review of 28 eyes of 23 patients with severe ocular chemical burns who had undergone Boston Keratoprosthesis (BKPro) surgery at the Massachusetts Eye and Ear Infirmary, between 1990 and 2010. The incidence and severity of the outcome of glaucoma, preoperatively and postoperatively, were reviewed. Related issues, such as type of chemical burn; visual acuity (VA); device retention rate; number and nature of previous, concomitant, and subsequent procedures; and incidence of other postoperative complications, were reviewed for a median follow-up time of 57 months.Results: The number of eyes with a preoperative history or signs of glaucoma was 21, 9 of which had glaucoma progression after BKPro implantation. In addition, 2 more eyes developed glaucoma postoperatively. Preoperative vision was counting fingers or worse in all eyes. Best-corrected postoperative VA ranged from no light perception to 20/20. Seventeen eyes (61%) achieved 20/60 or better VA at some point during their follow-up, but only 9 (32%) maintained 20/60 at the last follow-up. Of the 28 eyes, 6 had the BKPro replaced once and 1 had it replaced twice. Superimposed, 8 of the most severely burned patients developed retinal detachment postoperatively.Conclusions: Glaucoma is very common in eyes with severe chemical burns. A keratoprosthesis can rehabilitate vision, but postoperative glaucoma can be difficult to manage.