Boston Ⅰ型角膜假体相关性角膜融解的临床特征和预后。

Clinical features and prognosis of Boston type I keratoprosthesis-associated corneal melt.

机构信息

Ocular Surface Disease and Dry Eye Clinic, Cornea and External Disease Service, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-9238, USA.

出版信息

Ocul Immunol Inflamm. 2011 Dec;19(6):413-8. doi: 10.3109/09273948.2011.621580.

DOI:10.3109/09273948.2011.621580

PMID:22106908

Abstract

PURPOSE

To describe the clinical features and outcomes of corneal melt associated with Boston type I keratoprosthesis (KPro) implantation.

METHODS

Medical records of patients who experienced corneal melt following KPro implantation were reviewed retrospectively.

RESULTS

Sixty-six adult patients had KPro implantation from January 2004 to November 2010. Six patients had an underlying inflammatory ocular surface disorder. Four experienced corneal melt (6.1%) 5-42 months after the initial surgery. One patient was diagnosed with Sjögren's syndrome as a result of diagnostic workup following melt. Three patients were treated with systemic immunomodulatory therapy; two experienced fungal keratitis and subsequent endophthalmitis. KPro had to be explanted and replaced with donor cornea in all cases.

CONCLUSIONS

KPro-associated corneal melt is uncommon and appears to occur in patients with preexisting inflammatory disorders, which might not have been previously diagnosed. Timely explantation of KPro and replacement with donor cornea may prevent a poor outcome.

摘要

目的

描述与 Boston Ⅰ型角膜假体（KPro）植入相关的角膜融解的临床特征和结果。

方法

回顾性分析了 66 例接受 KPro 植入术后发生角膜融解的患者的病历。

结果

2004 年 1 月至 2010 年 11 月，66 例成年患者接受了 KPro 植入术。6 例患者存在潜在的炎症性眼表疾病。4 例患者在初次手术后 5-42 个月发生角膜融解（6.1%）。1 例患者在融解后行诊断性检查，诊断为干燥综合征。3 例患者接受了全身免疫调节治疗；2 例患者发生真菌性角膜炎，随后发生眼内炎。所有患者均需行 KPro 摘除，并更换供体角膜。