Matthaei M, Bachmann B, Hos D, Siebelmann S, Schaub F, Cursiefen C
Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland.
Zentrum für Molekulare Medizin Köln (ZMMK), Universität zu Köln, Köln, Deutschland.
Ophthalmologe. 2019 Jan;116(1):67-72. doi: 10.1007/s00347-018-0806-x.
Keratoprosthetics refer to the replacement of human corneal tissue with an artificially produced exchange product. The most widely implanted keratoprosthesis worldwide is the Boston Type I Keratoprosthesis (BI-KPro, Massachusetts Eye and Ear Infirmary, Boston, MA, USA).
This video article demonstrates the surgical technique of BI-KPro implantation as routinely performed at this institution. In addition, an overview of the surgical indications, patient consent, anesthesia and positioning, postoperative treatment and complications as well as the evidence of the technique is provided in the article based on experience with 31 BI-KPro implantations.
The indications for BI-KPro primarily include patients in a high-risk keratoplasty setting particularly after repeatedly failed keratoplasty. A thorough patient examination and assessment of the indications as well as detailed disclosure of information to the patient about the individual prognosis, the risk profile, the postoperative therapy and follow-up enable a positive postoperative result.
The BI-KPro provides an established and relatively standardized option for surgical treatment of eyes in a high-risk keratoplasty setting. Patients should be preoperatively informed with respect to the individual prognosis, complication profile and life-long follow-up.
角膜假体是指用人造的替代产品替换人角膜组织。全球应用最广泛的角膜假体是波士顿I型角膜假体(BI-KPro,美国马萨诸塞州波士顿市麻省眼耳医院)。
本文视频展示了本机构常规进行的BI-KPro植入手术技术。此外,本文还根据31例BI-KPro植入经验,概述了手术适应症、患者知情同意、麻醉与体位、术后治疗与并发症以及该技术的证据。
BI-KPro的适应症主要包括角膜移植高风险患者,尤其是多次角膜移植失败后。对患者进行全面检查和适应症评估,并向患者详细披露有关个体预后、风险状况、术后治疗和随访的信息,可使术后结果良好。
BI-KPro为角膜移植高风险患者的手术治疗提供了一种成熟且相对标准化的选择。应在术前告知患者个体预后、并发症情况及终身随访事宜。