Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
Department of Ophthalmology, McGill University, Montreal, Quebec, Canada.
Br J Ophthalmol. 2022 Jul;106(7):929-934. doi: 10.1136/bjophthalmol-2020-317483. Epub 2021 Mar 3.
BACKGROUND/AIMS: To evaluate the time needed for patients with Boston type 1 keratoprosthesis (KPro) to reach their best-corrected visual acuity (BCVA) and all contributing factors.
We retrospectively reviewed 137 consecutive eyes from 118 patients, measured how long they needed to reach their BCVA and looked at factors that might affect this time duration including patient demographics, ocular comorbidities and postoperative complications.
The mean follow-up was 5.49 years. The median time to BCVA postoperatively was 6 months, with 47% of patients achieving their BCVA by 3 months. The mean best achieved logMAR visual acuity was 0.71, representing a gain of 6 lines on the Snellen visual acuity chart. Postoperative glaucoma, retroprosthetic membrane (RPM) and endophthalmitis prolonged this duration. We found no correlation between the following factors and time to BCVA: gender, age, indication for KPro surgery, primary versus secondary KPro, number of previous penetrating keratoplasties, previous retinal surgery, intraoperative anterior vitrectomy and preoperative glaucoma.
In our retrospective cohort, the majority of subjects reached their BCVA between 3 and 6 months after KPro implantation. This duration was significantly prolonged by the development of postoperative glaucoma, RPM and endophthalmitis.
背景/目的：评估波士顿 1 型角膜假体（KPro）患者达到最佳矫正视力（BCVA）所需的时间及其所有影响因素。
我们回顾性分析了 118 例 137 只连续眼，测量了达到 BCVA 所需的时间，并观察了可能影响这一时间的因素，包括患者人口统计学、眼部合并症和术后并发症。
平均随访时间为 5.49 年。术后达到 BCVA 的中位数时间为 6 个月，47%的患者在 3 个月内达到 BCVA。最佳获得的对数视力平均值为 0.71，相当于 Snellen 视力表上提高了 6 行。术后青光眼、后弹力膜（RPM）和眼内炎延长了这一时期。我们发现以下因素与 BCVA 时间之间无相关性：性别、年龄、KPro 手术指征、原发性与继发性 KPro、既往穿透性角膜移植术次数、既往视网膜手术、术中前玻璃体切除术和术前青光眼。
在我们的回顾性队列中，大多数患者在 KPro 植入后 3 至 6 个月达到 BCVA。术后青光眼、RPM 和眼内炎的发生显著延长了这一时期。
