Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida.
Wills Eye Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Curr Opin Ophthalmol. 2021 Jul 1;32(4):385-388. doi: 10.1097/ICU.0000000000000774.
The Boston Keratoprosthesis Type 1 was pioneered by Claes Dohlman several decades ago. Since its inception, the device has undergone multiple revisions to address challenges associated with retroprosthetic membrane formation, retention, extrusion, stromal melt and endophthalmitis. Although visual outcomes and retention rates have improved, challenges, especially glaucoma, remain.
The Boston Keratoprosthesis Type I device has seen an increase in popularity because of the improvement in rates of retention and visual rehabilitation. Recent outcome studies have allowed clinicians to identify diagnoses and indications that can lead to more favorable results with the Boston Keratoprosthesis Type I device.
The Boston Keratoprosthesis Type I device continues to play a vital role in visual rehabilitation for eyes with very low chance of realistic allograft survival -- such as in eyes where corneal grafting is considered high-risk: eyes with corneal limbal stem cell failure, extensive deep corneal stromal neovascularization, and multiple allograft failures. This review article summarizes the perioperative and postoperative challenges, as well as other considerations associated with the device.
几十年来，Claes Dohlman 率先开发了 1 型波士顿角膜假体。自成立以来，该设备已经进行了多次修订，以解决与后假体膜形成、保留、挤出、基质融化和眼内炎相关的挑战。尽管视力结果和保留率有所提高，但仍存在挑战，尤其是青光眼。
1 型波士顿角膜假体设备的普及度有所增加，因为其保留率和视觉康复率有所提高。最近的结果研究使临床医生能够确定诊断和适应证，从而使 1 型波士顿角膜假体设备获得更有利的结果。
1 型波士顿角膜假体设备在那些现实异体移植物存活率极低的眼睛的视力康复中继续发挥重要作用，例如在角膜移植被认为风险较高的情况下：角膜缘干细胞衰竭、广泛深层角膜基质新生血管形成和多次异体移植物失败的眼睛。本文综述了该设备相关的围手术期和术后挑战以及其他注意事项。
