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首页> 外文期刊>British journal of ophthalmology >A brief review of Boston type-1 and osteo-odonto keratoprostheses
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A brief review of Boston type-1 and osteo-odonto keratoprostheses

机译：波士顿1型和骨-齿牙本质角膜假体的简要概述

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Globally there are approximate to 4.9 million bilaterally corneal blind and 23 million unilaterally corneal blind. Majority of this blindness exists in the developing countries, where resources for corneal banking and transplant surgery are less than adequate. Survival of corneal grafts gradually declines over the long term. Corneal transplantation has poor prognosis in vascularised corneal beds, ocular surface disease and viral keratitis. Keratoprosthesis (KPro) remains as a final option for end-stage ocular surface disease, multiple corneal transplant failures and high-risk corneal grafts. Boston type-1 KPro and osteo-odonto-keratoprosthesis are the two devices proven useful in recent years. Choice of a keratoprosthetic device is patient specific based on the underlying diagnosis, ocular morbidity and patient suitability. KPro surgery demands a high level of clinical and surgical expertise, lifelong commitment and extensive resources. Improvements in techniques and biomaterials may in the future provide retainable KPros that do not need regular follow-up of patients, have low complications but high retention rates and may be produced at a low cost on a mass scale to be available as 'off the shelf' devices. Because KPros have the potential to effectively address the burden of surgically treatable corneal blindness and may also eliminate the problems of corneal transplantation, more research is required to develop KPros as substitutes for corneal transplantation even in low-risk cases. In those countries where corneal blindness is a major liability, we need a two pronged approach: one to develop eye donation, eye banking and corneal transplantation and the second to establish centres for keratoprostheses, which are affordable and technically not challenging, in a population where default on follow-up visits are high. Until the latter is achieved, KPros should be viewed as a temporary means for visual restoration and be offered in national and supraregional specialised centres only.
机译：在全球范围内，大约有490万双侧角膜盲和2300万单侧角膜盲。这种盲症的大多数存在于发展中国家，那里用于角膜储存和移植手术的资源不足。长期来看，角膜移植物的存活率逐渐下降。角膜移植在血管化角膜床，眼表疾病和病毒性角膜炎中预后较差。角膜塑形术（KPro）仍然是终末期眼表疾病，多次角膜移植失败和高风险角膜移植的最终选择。波士顿1型KPro和骨-齿-齿-角膜假体是近年来被证明有用的两种设备。根据潜在的诊断，眼病和患者的适应性，选择角膜修复设备是患者特定的。 KPro手术需要高水平的临床和外科专业知识，终身承诺和广泛的资源。技术和生物材料的改进将来可能会提供可保留的KPro，这些患者无需定期随访，并发症少，但保留率高，并且可能以低成本大规模生产，以备有现货' 设备。由于KPro可以有效解决可手术治疗的角膜盲症的负担，并且还可以消除角膜移植的问题，因此，即使在低风险的情况下，也需要开展更多的研究来开发KPro来替代角膜移植。在那些以角膜盲为主要责任的国家中，我们需要采取两种有针对性的方法：一种是在人口稠密的人群中开发眼捐赠，眼库和角膜移植的方法，另一种是建立价格合理且技术上没有挑战的角膜修复中心。后续访问的默认值很高。在实现后者之前，应将KPros视为视觉恢复的临时手段，仅在国家和地区以上的专业中心提供。

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