CJ Shah Cornea Services/Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Indian J Ophthalmol. 2018 May;66(5):620-629. doi: 10.4103/ijo.IJO_22_18.
Keratoprosthesis (Kpro) forms the last resort for bilateral end-stage corneal blindness. The Boston Type 1 and 2 Kpros, the modified osteo-odonto Kpro and the osteo-Kpro are the more frequently and commonly performed Kpros, and this review attempts to compile the current data available on these Kpros worldwide from large single-center studies and compare the indications and outcomes with Kpros in the Indian scenario. Although the indications have significantly expanded over the years and the complications have reduced with modifications in design and postoperative regimen, these are procedures that require an exclusive setup, and a commitment toward long-term follow-up and post-Kpro care. The last decade has seen a surge in the number of Kpro procedures performed worldwide as well as in India. There is a growing need in our country among ophthalmologists to be aware of the indications for Kpro to facilitate appropriate referral as well as of the procedure to enable basic evaluation during follow-ups in case the need arises, and among corneal specialists interested to pursue the field of Kpros in understanding the nuances of these surgeries and to make a judicious decision regarding patient and Kpro selection and more importantly deferral.
角膜假体（Keratoprosthesis，Kpro）是治疗双侧终末期角膜盲的最后手段。波士顿 1 型和 2 型 Kpro、改良骨-牙 Kpro 和骨 Kpro 是更常进行的 Kpro，本综述试图从大型单中心研究中汇集全球关于这些 Kpro 的现有数据，并将其与印度的 Kpro 情况进行比较。尽管这些适应证多年来显著扩大，并且设计和术后方案的改进降低了并发症，但这些手术需要专门的设备，并需要长期随访和 Kpro 后护理的承诺。过去十年，全球以及印度的 Kpro 手术数量都有所增加。我们国家的眼科医生越来越需要了解 Kpro 的适应证，以便能够进行适当的转诊，以及了解该手术，以便在需要时在随访期间进行基本评估，对于有兴趣从事 Kpro 领域的角膜专家，了解这些手术的细微差别，并就患者和 Kpro 的选择做出明智的决定，更重要的是要推迟手术。
