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首尔型角膜移植术治疗顽固性眼表疾病的长期疗效

Long-term outcome in ocular intractable surface disease with Seoul-type keratoprosthesis.

作者信息

Kim Mee Kum, Lee Sang Mok, Lee Jae Lim, Chung Tae Young, Kim Young Ha, Wee Won Ryang, Lee Jin Hak

机构信息

Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.

出版信息

Cornea. 2007 Jun;26(5):546-51. doi: 10.1097/ICO.0b013e3180415d35.

Abstract

PURPOSE

To evaluate the long-term clinical efficacy of the Seoul-type keratoprosthesis (S-KPro).

METHODS

S-KPros were implanted into 4 unsighted and 5 sighted eyes in 9 patients: 6 patients were diagnosed with Stevens-Johnson syndrome, 2 had chemical burns, and 1 suffered from ocular pemphigoid. The preoperative visual acuity ranged from light perception to hand motion. The average follow-up period was 62.8 months. We evaluated several clinical factors, including visual acuity, visual field, number of additional grafting procedures, number of capsulotomy procedures, and the interval between retinal detachment and skirt exposure.

RESULTS

The S-KPro showed anatomic success for an average of 62.8 months in 66.7% of the eyes. The average visual acuity preservation time was 31.6 months. Localized glaucomatous visual field defect was not found in any of the sighted patients; however, diffuse visual field constriction was observed after long-term follow-up. Average time of skirt exposure and mean number of additional grafting procedures were 12.9 months and 2.44, respectively. Retinal detachments were developed in all the patients at a mean time interval of 2 months after S-KPro exchange.

CONCLUSIONS

S-KPro achieved visual rehabilitation for an average of 31.6 months with long-term anatomic stability in patients with severe intractable ocular surface disease.

摘要

目的

评估首尔型人工角膜(S-KPro)的长期临床疗效。

方法

将S-KPro植入9例患者的4只盲眼和5只视力尚存的眼睛中:6例患者诊断为史蒂文斯-约翰逊综合征,2例为化学伤,1例为眼部类天疱疮。术前视力范围从光感至手动。平均随访期为62.8个月。我们评估了几个临床因素,包括视力、视野、额外移植手术的次数、晶状体囊切开术的次数以及视网膜脱离与裙边暴露之间的间隔时间。

结果

S-KPro在66.7%的眼睛中平均62.8个月实现了解剖学成功。平均视力保留时间为31.6个月。所有视力尚存的患者均未发现局限性青光眼性视野缺损;然而,长期随访后观察到弥漫性视野缩窄。裙边暴露的平均时间和额外移植手术的平均次数分别为12.9个月和2.44次。在更换S-KPro后,所有患者均发生视网膜脱离,平均时间间隔为2个月。

结论

对于患有严重难治性眼表疾病的患者,S-KPro平均31.6个月实现了视力康复,并具有长期的解剖学稳定性。

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