Hollick E J, Watson S L, Dart J K G, Luthert P J, Allan B D S
Department of Ophthalmology, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
Br J Ophthalmol. 2006 Sep;90(9):1146-51. doi: 10.1136/bjo.2006.092510.
The long term results of the Legeais BioKpro III keratoprosthesis are presented for seven patients with severe corneal scarring.
The study took place at Moorfields Eye Hospital, London. Patients had either end stage ocular surface disease or corneal opacification after multiple failed graft surgery, with the potential for significant visual improvement. After insertion the device was covered with a conjunctival flap or buccal mucous membrane graft, which was later opened to expose the optic. The outcome measures were vision, complications, and retention of the device.
The BioKpro III was inserted into seven patients with severe corneal scarring: ocular cicatricial pemphigoid, measles keratitis, thermal injury, Stevens-Johnson syndrome, aniridia, chemical injury, and congenital rubella. The follow up was 18-48 months. The keratoprosthesis failed in six, because of extrusion occurring 2-28 months postoperatively. Retroprosthetic membranes occurred in three patients, and endophthalmitis in one. Vision improved from hand movements to 6/12 in the only patient who retained the KPro; however he was troubled by mucus accumulation on the optic.
The one success has been in a patient with thermal burns. The remaining results have been poor, with the KPro extruding in six of the seven patients.
报告7例严重角膜瘢痕患者使用Legeais BioKpro III人工角膜的长期结果。
该研究在伦敦的摩尔菲尔德眼科医院进行。患者患有终末期眼表疾病或多次移植手术失败后的角膜混浊,有显著视力改善的可能。植入后,该装置用结膜瓣或颊黏膜移植片覆盖,随后打开以暴露视盘。观察指标为视力、并发症和装置的留存情况。
BioKpro III人工角膜植入7例严重角膜瘢痕患者:瘢痕性类天疱疮、麻疹性角膜炎、热烧伤、史蒂文斯-约翰逊综合征、无虹膜、化学伤和先天性风疹。随访时间为18至48个月。6例人工角膜失败,原因是术后2至28个月发生了排斥反应。3例患者出现了人工角膜后膜,1例发生了眼内炎。在唯一留存人工角膜的患者中,视力从手动改善到了6/12;然而,他因视盘上有黏液积聚而感到困扰。
唯一成功的是一名热烧伤患者。其余结果不佳,7例患者中有6例人工角膜发生了排斥反应。