No Light Perception Outcomes Following Boston Keratoprosthesis Type 1 Surgery

作者：Muzychuk Adam K^*; Durr Georges M; Shine Julien J; Robert Marie Claude; Harissi Dagher Mona

来源：American Journal of Ophthalmology, 2017, 181: 46-54.

DOI：10.1016/j.ajo.2017.06.012

PURPOSE: To determine the incidence rate, principal causes, and clinical course of eyes developing no light perception (NLP) visual acuity (VA) following Boston Keratoprosthesis (B-KPro) type 1 surgery. Secondary objectives include determining the incidence rate, relative risk (RR), and survival probability with respect to NLP outcomes among eyes with congenital aniridia.
DESIGN: Retrospective, interventional case series.
SUBJECTS: All patients undergoing B-KPro type 1 surgery between October 2008 and June 2016 by a single surgeon at CHUM Hopital Notre-Dame.
METHODS: Records of patients having undergone B-KPro implantation were reviewed. Eyes with a final outcome of NLP were further reviewed to determine best recorded postoperative VA, time to NLP onset, clinical course, and principal cause. Descriptive statistics, incidence rates, Kaplan-Meier survival curves, and the RR of NLP outcomes among eyes with aniridia were determined. Statistical significance was defined as P < .05.
RESULTS: Records of 119 patients were included, with an average follow-up of 49.1 +/- 26.8 months postoperatively. Nineteen eyes had a final outcome of NLP, representing 16.0%. The incidence rate of NLP was 0.04 cases per eye-year of follow-up. The most common principal causes were inoperable retinal detachment (n = 7, 36.8%), terminal glaucoma (n = 6, 31.6%), and carrier graft melt-related complications (n = 5, 26.3%). The RR of developing NLP among eyes with aniridia was 3.04 (P = .01).
CONCLUSIONS: No light perception is a devastating but uncommon outcome of B-KPro surgery. Patients with aniridia seem to be at increased risk. In spite of all available medical and surgical interventions, some eyes may still suffer this outcome.

• 出版日期2017-9