Journal of current ophthalmology · 2026
Twelve-Month Visual and Anatomical Outcomes of Boston Type I Keratoprosthesis in Four Patients with Multiple Graft Failures and Severe Ocular Pathology.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ghasemi Hamed, Farsi Pirouzeh, Zangouei Amirsadra, Hashemi Hassan
Аннотация
PURPOSE: To assess 12-month visual acuity, anatomic integrity, and complication rates after Boston Type I Keratoprosthesis (BKPro-I) implantation in eyes with multiple failed penetrating keratoplasties and complex anterior segment pathology.
METHODS: In this prospective case series, four eyes (mean age, 32 ± 9 years) received BKPro-I between January and June 2022. All surgeries employed polymethylmethacrylate front plates, customized titanium back plates, and a standardized perioperative regimen (IV cefazolin, topical vancomycin + levofloxacin, corticosteroid taper, nightly povidone-iodine, selective antifungal prophylaxis) with early 16 mm scleral lens fitting. Follow-up occurred at 3 days, 1 week, 2 weeks, monthly to 3 months, then quarterly to 12 months postoperatively. Primary outcomes were best-corrected visual acuity (BCVA), device retention, and sight-threatening complications.
RESULTS: At 12 months, all devices were retained. Functional success (BCVA ≥20/200) was achieved in 100% of eyes in 6 months; at 12 months, 75% reached ≥20/100 and 50% ≥20/60 (mean gain ≥5 ETDRS lines). Two eyes (50%) developed complications - retroprosthetic membranes, vitritis/suspected endophthalmitis, stromal melting, chronic hypotony, and silicone-oil leak - all managed without device loss; one eye's vision declined to finger counting at month 7 but remained ambulatory.
CONCLUSIONS: BKPro-I yields excellent short-term visual rehabilitation and perfect retention in highly complex eyes. However, a 50% complication rate mandates rigorous patient selection, standardized perioperative protocols, and lifelong multidisciplinary follow-up.
METHODS: In this prospective case series, four eyes (mean age, 32 ± 9 years) received BKPro-I between January and June 2022. All surgeries employed polymethylmethacrylate front plates, customized titanium back plates, and a standardized perioperative regimen (IV cefazolin, topical vancomycin + levofloxacin, corticosteroid taper, nightly povidone-iodine, selective antifungal prophylaxis) with early 16 mm scleral lens fitting. Follow-up occurred at 3 days, 1 week, 2 weeks, monthly to 3 months, then quarterly to 12 months postoperatively. Primary outcomes were best-corrected visual acuity (BCVA), device retention, and sight-threatening complications.
RESULTS: At 12 months, all devices were retained. Functional success (BCVA ≥20/200) was achieved in 100% of eyes in 6 months; at 12 months, 75% reached ≥20/100 and 50% ≥20/60 (mean gain ≥5 ETDRS lines). Two eyes (50%) developed complications - retroprosthetic membranes, vitritis/suspected endophthalmitis, stromal melting, chronic hypotony, and silicone-oil leak - all managed without device loss; one eye's vision declined to finger counting at month 7 but remained ambulatory.
CONCLUSIONS: BKPro-I yields excellent short-term visual rehabilitation and perfect retention in highly complex eyes. However, a 50% complication rate mandates rigorous patient selection, standardized perioperative protocols, and lifelong multidisciplinary follow-up.