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自体耳软骨增强改良波士顿 II 型角膜假体植入的短期疗效。

Short-Term Outcomes of Modified Boston Type-II Keratoprosthesis Implantation With Autologous Auricular Cartilage Reinforcement.

机构信息

From the National Clinical Research Center for Ocular Diseases (M.L., H.W., L.L., C.G., L.G., Q.Z., W.C.), Eye Hospital, Wenzhou Medical University, Wenzhou, China; Department of Ophthalmology (M.L., L.G., W.C.), Boao Super Hospital, Hainan, China.

From the National Clinical Research Center for Ocular Diseases (M.L., H.W., L.L., C.G., L.G., Q.Z., W.C.), Eye Hospital, Wenzhou Medical University, Wenzhou, China.

出版信息

Am J Ophthalmol. 2023 Aug;252:205-212. doi: 10.1016/j.ajo.2023.03.004. Epub 2023 Mar 20.

Abstract

PURPOSE

To report the short-term visual outcomes and complications of a modified Boston Type-II keratoprosthesis (Kpro) procedure.

DESIGN

Retrospective case series.

METHODS

Thirty-seven eyes of 37 patients who had an implantation of autologous auricular cartilage-reinforced (AACR) Boston Type-II Kpro (BK2) were included in the current study. Preoperative and postoperative data were recorded and analyzed for each eye. Main outcome measures included best-corrected visual acuity, symptoms as assessed by questionnaires, complications associated with implantation, and retention of the implanted BK2 device.

RESULTS

A total of 37 eyes, consisting of 19 with severe autoimmune dry eye (ADE) and 18 with burn injury, completed ≥12 months of follow-up. The median (interquartile range) best-corrected visual acuity at baseline, 1 month, 3 months, 6 months, 1 year, and 2 years of follow-up was hand motion (HM) 20/60 (20/100-20/40), 20/60 (20/200-20/40), 20/60 (20/200-20/40), 20/100 (20/200-20/40), and 20/100 (20/400-20/40), respectively. All eyes retained the initial device (37/37, 100%). Common postoperative complications included retroprosthetic membrane (n = 21), de novo glaucoma (n = 7), endophthalmitis (n = 1), and conjunctival erosion (n = 4). No ear complications were discovered during follow-up assessments. The ocular surface disease index score improved from baseline to a 2-year follow-up (median 57.5 vs 21.43).

CONCLUSION

The modified AACR-BK2 procedure could be considered to restore vision in patients with end-stage corneal blindness.

摘要

目的

报告改良型波士顿 II 型角膜(Kpro)手术的短期视力结果和并发症。

设计

回顾性病例系列。

方法

纳入了 37 例 37 只眼的自体耳软骨增强(AACR)波士顿 II 型 Kpro(BK2)植入患者,对每只眼的术前和术后数据进行了记录和分析。主要观察指标包括最佳矫正视力、问卷调查评估的症状、与植入相关的并发症以及植入的 BK2 装置的保留情况。

结果

共有 37 只眼(19 只眼为严重自身免疫性干燥性眼病(ADE),18 只眼为烧伤)完成了≥12 个月的随访。基线、1 个月、3 个月、6 个月、1 年和 2 年随访时的中位(四分位间距)最佳矫正视力分别为手动视力(HM)20/60(20/100-20/40)、20/60(20/200-20/40)、20/60(20/200-20/40)、20/100(20/200-20/40)和 20/100(20/400-20/40)。所有眼均保留了初始装置(37/37,100%)。常见的术后并发症包括后发性人工角膜膜(n=21)、新生青光眼(n=7)、眼内炎(n=1)和结膜侵蚀(n=4)。在随访评估中未发现耳部并发症。眼表疾病指数评分从基线到 2 年随访时改善(中位数 57.5 比 21.43)。

结论

改良型 AACR-BK2 手术可考虑用于恢复终末期角膜盲患者的视力。

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