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Endoscopic Cyclophotocoagulation in Boston Keratoprosthesis Type II

机译：内窥镜Cyclophotocoagulation在波士顿

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The Boston keratoprosthesis has become the most commonly used artificial cornea in the world since its approval for marketing by the US Food and Drug Administration in 1992. Boston keratoprosthesis type II (KPro II) surgery is indicated in patients with severe ocular surface disease. The KPro II is a modified version of the keratoprosthesis type I and involves implantation of a device that is enveloped by surgically closed eyelids. Glaucoma is common after KPro II surgery due to the worsening of existing glaucoma or new-onset glaucoma from inflammation and peripheral anterior synechiae. Most patients receive an Ahmed valve (New World Medical, Inc.) prophylactically at the time of primary KPro II surgery. The tube is typically placed inferiorly, preserving the ability to dissect through the superior lid for surgical access if additional procedures become necessary; post-KPro II inferior lid dissection is more difficult and poses greater surgical access challenges. Topical drops penetrate poorly through the tarsorrhaphy; therefore, glaucoma treatment for KPro II is mostly limited to oral carbonic anhydrase inhibitors, tube shunts, and cyclodestruction. The primary Ahmed valve is preferred over primary endoscopic cyclophotocoagulation (ECP) because tubes traditionally provide more durable and effective intraocular pressure (IOP) lowering than ECP.
机译：波士顿keratoprosthesis已成为最世界上常用的人工角膜批准以来由美国食品市场与药物管理局在1992年。keratoprosthesis II型(KPro II)手术患者表示严重的眼部表面疾病。keratoprosthesis I型和涉及植入的设备,由外科包膜闭着眼睛的。由于不断恶化的现有的青光眼手术或者从炎症和最近诊断为青光眼周边前房粘连。收到一个Ahmed阀(新的世界医学,Inc .)预防性的时候主要KPro II手术。解剖的保护能力如果额外的上盖为外科访问程序成为必要;下盖和解剖更困难提出了更大的外科访问挑战。通过tarsorrhaphy滴渗透差;因此,青光眼治疗KPro二世主要局限于口服碳酸酐酶抑制剂,管分流术,cyclodestruction。主Ahmed阀主要是首选内窥镜cyclophotocoagulation (ECP)因为管和传统上提供更持久有效的降低眼内压(IOP)比项目。

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