Silva Luzia Diegues, Santos Albert, Sousa Luciene Barbosa de, Allemann Norma, Oliveira Lauro Augusto de
Department of Ophthalmology and Visual Sciences, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Department of Ophthalmology & Visual Sciences, University of Illinois, Chicago, IL, USA.
Arq Bras Oftalmol. 2018 Jan-Feb;81(1):42-46. doi: 10.5935/0004-2749.20180010.
To report the results of high-resolution anterior segment optical coherence tomography of patients implanted with a type 1 Boston keratoprosthesis (KPro).
The retrospective study cohort included 11 eyes of 11 patients (average age, 58.4 years; range, 34-83 years). All subjects underwent anterior segment optical coherence tomography at a single posteoperative time point. The main outcome measures were retro-backplate and retro-optic membrane formation, thinning and gap formation of the corneal carrier graft (melting), and degree of angle closure.
Preoperative diagnoses included chemical burn (55%), failed corneal transplant (36%), and Stevens-Johnson syndrome (9%). The mean postoperative follow-up duration was 38.5 (range, 12-72) months. The most frequent findings of anterior segment optical coherence tomography were retroprosthetic membrane formation (63%, 7/11), thinning of the corneal carrier graft (melting; 55%, 6/11), and a narrow or closed angle (91%, 10/11). Other less common findings were epithelial growth over the optic surface and periprosthetic cyst formation. Retroprosthetic membrane formation was observed in all patients with melting (6/11).
Detailed postoperative examination and visualization of subtle changes of keratoprosthesis implanted eyes by slit lamp biomicroscopy are often difficult. Anterior segment optical coherence tomography is a useful, noninvasive, and quantitative imaging technique that provides useful information to postoperatively monitor the anatomic stability of an implanted keratoprosthesis.
报告植入1型波士顿人工角膜(KPro)患者的高分辨率眼前节光学相干断层扫描结果。
回顾性研究队列包括11例患者的11只眼(平均年龄58.4岁;范围34 - 83岁)。所有受试者在术后单一时间点接受眼前节光学相干断层扫描。主要观察指标为后板和视神经膜形成、角膜载体移植物变薄和间隙形成(融化)以及房角关闭程度。
术前诊断包括化学伤(55%)、角膜移植失败(36%)和史蒂文斯 - 约翰逊综合征(9%)。术后平均随访时间为38.5(范围12 - 72)个月。眼前节光学相干断层扫描最常见的发现是人工角膜后膜形成(63%,7/11)、角膜载体移植物变薄(融化;55%,6/11)和房角狭窄或关闭(91%,10/11)。其他较不常见的发现是视神经表面上皮生长和人工角膜周围囊肿形成。在所有发生融化的患者(6/11)中均观察到人工角膜后膜形成。
通过裂隙灯生物显微镜对植入人工角膜的眼睛进行详细的术后检查和细微变化的可视化往往很困难。眼前节光学相干断层扫描是一种有用的、非侵入性的定量成像技术,可为术后监测植入人工角膜的解剖稳定性提供有用信息。