Jardeleza Maria Stephanie R, Rheaume Marc-Andre, Chodosh James, Lane Anne Marie, Dohlman Claes H
Department of Ophthalmology, University of Texas Health Science Center in San Antonio-Texas Diabetes Institute, San Antonio, Texas;
Retina Service, Department of Ophthalmology, University of Montreal, Quebec, Canada;
Digit J Ophthalmol. 2015 Dec 21;21(4):1-15. doi: 10.5693/djo.01.2015.10.001. eCollection 2015.
To determine the rates, predisposing factors, and visual outcomes of retinal detachment (RD) after Boston Keratoprosthesis (KPro) implantation.
In this noncomparative, interventional case series, the medical records of 170 patients (205 eyes) who underwent Boston type 1 and type 2 KPro implantation at the Massachusetts Eye and Ear Infirmary between April 1993 and June 2009 were retrospectively reviewed. Incidence and annual rates of RD were calculated, and the roles of possible predictive factors for RD after KPro were investigated. Main outcome measures were rates of and risk factors for RD, visual acuity after RD, and surgical outcomes after repair.
Sterile vitritis and autoimmune systemic disease significantly predisposed patients to RD after KPro placement. Of patients who developed RD after implantation, 50% progressed to visual acuity of no light perception despite surgical repair.
Inflammation plays a major role in RD development after KPro implantation. Patients with predisposing factors should be advised of the high rates of RD and comanaged with a vitreoretinal specialist.
确定波士顿人工角膜（KPro）植入术后视网膜脱离（RD）的发生率、诱发因素及视力预后。
在这个非对照性的干预性病例系列研究中，对1993年4月至2009年6月期间在马萨诸塞州眼耳医院接受波士顿1型和2型KPro植入术的170例患者（205只眼）的病历进行回顾性分析。计算RD的发生率和年发生率，并研究KPro术后RD可能的预测因素的作用。主要观察指标为RD的发生率和危险因素、RD后的视力以及修复后的手术效果。
无菌性葡萄膜炎和自身免疫性全身性疾病显著增加了患者KPro植入术后发生RD的风险。植入后发生RD的患者中，50%尽管接受了手术修复，但视力仍进展至无光感。
炎症在KPro植入术后RD的发生中起主要作用。对于有诱发因素的患者，应告知其RD的高发生率，并与玻璃体视网膜专科医生共同管理。
