Aquavella James V, Qian Ying, McCormick Gregory J, Palakuru Jayachandra Reddy
University of Rochester Eye Institute, Rochester, MN, USA.
Cornea. 2006 Jul;25(6):656-62. doi: 10.1097/01.ico.0000214226.36485.d2.
To compare and contrast the techniques and results of keratoprosthesis (KPro) using the Cardona device (1975-1985) with those related to the use of the Dohlman-Doane type 1 device (2003-2005).
We conducted a retrospective review of 31 cases of Cardona KPro implanted between 1975 and 1981 and a review of 25 cases of Dohlman-Doane type 1 KPro implanted between 2003 and 2005. Procedures were limited to eyes with a poor prognosis for traditional penetrating keratoplasty.
In the Cardona cases, 39% (12/31) of patients achieved a visual acuity of 20/40 or better at some point postoperatively, degrading to 16% (5/31) at the end of the observation period. Fifty percent (15/31) required subsequent surgical revision of the KPro. Sixteen percent of cases (5/31) developed endophthalmitis, and 58% (18/31) developed retroprosthetic membranes. There were 5 dislocations of the prosthesis and an additional 3 frank extrusions (26%). Of the 25 Dohlman-Doane cases, there have been no reoperations, endophthalmitis, dislocations, or extrusions to date (8/15/05). Forty-eight percent (12/25) achieved 20/200 acuity or better, and 12% (3/25) achieved 20/40 or better. Retroprosthetic membranes formed in 3 cases.
Although KPro remains a technique to be used in poor prognosis keratoplasty, improvements in the design of the device and surgical technique over the past 30 years have reduced the overall morbidity and severity of complications and improved the prognosis for visual rehabilitation.
比较并对比使用卡尔多纳装置（1975 - 1985年）的角膜移植术（KPro）与使用多尔曼 - 多恩1型装置（2003 - 2005年）的角膜移植术的技术和结果。
我们对1975年至1981年间植入的31例卡尔多纳角膜移植术病例进行了回顾性研究，并对2003年至2005年间植入的25例多尔曼 - 多恩1型角膜移植术病例进行了回顾。手术仅限于传统穿透性角膜移植术预后较差的眼睛。
在卡尔多纳病例中，39%（12/31）的患者术后在某些时候视力达到20/40或更好，在观察期结束时降至16%（5/31）。50%（15/31）的患者需要对角膜移植术进行后续手术修正。16%的病例（5/31）发生了眼内炎，58%（18/31）发生了人工晶状体后膜。有5例人工晶状体脱位，另有3例明显脱出（26%）。在25例多尔曼 - 多恩病例中，截至2005年8月15日，尚无再次手术、眼内炎、脱位或脱出情况。48%（12/25）的患者视力达到20/200或更好，12%（3/25）的患者视力达到20/40或更好。有3例形成了人工晶状体后膜。
尽管角膜移植术仍是用于预后较差的角膜移植的一种技术，但在过去30年中，装置设计和手术技术的改进降低了总体发病率和并发症的严重程度，并改善了视力恢复的预后。
