Wissam B Nassrallah, Emma Youhnovska, Mai Katbe, Andre Pollmann, Fady Sedarous, Rayan Tolba, Dominique Geoffrion, Mona Harissi-Dagher
{"title":"重复I型波士顿角膜假体的远期预后。","authors":"Wissam B Nassrallah, Emma Youhnovska, Mai Katbe, Andre Pollmann, Fady Sedarous, Rayan Tolba, Dominique Geoffrion, Mona Harissi-Dagher","doi":"10.1016/j.jcjo.2025.06.027","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The Boston Type I keratoprosthesis (B-KPro) is a synthetic corneal implant used to restore vision in cases of corneal blindness. While the B-KPro can achieve a visual acuity of better than 20/200, it is associated with a risk of implant failure. In cases of failure, a repeat B-KPro may offer another opportunity for vision restoration. This study aims to evaluate the long-term outcomes of patients undergoing repeat B-KPro after failure of the initial implant.</p><p><strong>Design: </strong>This is a retrospective cohort study.</p><p><strong>Participants: </strong>Eighteen patients who underwent two B-KPro implantations in the same eye, with a mean follow-up period of 8.1 ± 4.6 years.</p><p><strong>Methods: </strong>The primary endpoints were the failure rate of the implant and visual acuity at the last follow-up.</p><p><strong>Results: </strong>The failure rate of the repeat B-KPro (11.11% at 5 years) was significantly lower than that of the first B-KPro (88.89% at 5 years) (p < 0.0001) for the repeat cohort. Visual acuity better than 20/200 was achieved in 30.09% and 24.07% of patients at 3 years and 6 years, respectively, following repeat B-KPro, similar to outcomes observed after the first B-KPro. The incidence of phthisis was higher after the repeat B-KPro, but the rates of hypotony, endophthalmitis, corneal melt, and extrusion were lower compared to the first B-KPro.</p><p><strong>Conclusions: </strong>Repeat B-KPro can provide sustained visual acuity better than 20/200 after failure of the initial implant. Further studies with larger cohorts are needed to better understand the risks and benefits associated with repeat B-KPro.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long-term prognosis of repeat Type I Boston keratoprosthesis.\",\"authors\":\"Wissam B Nassrallah, Emma Youhnovska, Mai Katbe, Andre Pollmann, Fady Sedarous, Rayan Tolba, Dominique Geoffrion, Mona Harissi-Dagher\",\"doi\":\"10.1016/j.jcjo.2025.06.027\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The Boston Type I keratoprosthesis (B-KPro) is a synthetic corneal implant used to restore vision in cases of corneal blindness. While the B-KPro can achieve a visual acuity of better than 20/200, it is associated with a risk of implant failure. In cases of failure, a repeat B-KPro may offer another opportunity for vision restoration. This study aims to evaluate the long-term outcomes of patients undergoing repeat B-KPro after failure of the initial implant.</p><p><strong>Design: </strong>This is a retrospective cohort study.</p><p><strong>Participants: </strong>Eighteen patients who underwent two B-KPro implantations in the same eye, with a mean follow-up period of 8.1 ± 4.6 years.</p><p><strong>Methods: </strong>The primary endpoints were the failure rate of the implant and visual acuity at the last follow-up.</p><p><strong>Results: </strong>The failure rate of the repeat B-KPro (11.11% at 5 years) was significantly lower than that of the first B-KPro (88.89% at 5 years) (p < 0.0001) for the repeat cohort. Visual acuity better than 20/200 was achieved in 30.09% and 24.07% of patients at 3 years and 6 years, respectively, following repeat B-KPro, similar to outcomes observed after the first B-KPro. The incidence of phthisis was higher after the repeat B-KPro, but the rates of hypotony, endophthalmitis, corneal melt, and extrusion were lower compared to the first B-KPro.</p><p><strong>Conclusions: </strong>Repeat B-KPro can provide sustained visual acuity better than 20/200 after failure of the initial implant. Further studies with larger cohorts are needed to better understand the risks and benefits associated with repeat B-KPro.</p>\",\"PeriodicalId\":9606,\"journal\":{\"name\":\"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-08-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Canadian journal of ophthalmology. 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Long-term prognosis of repeat Type I Boston keratoprosthesis.
Objective: The Boston Type I keratoprosthesis (B-KPro) is a synthetic corneal implant used to restore vision in cases of corneal blindness. While the B-KPro can achieve a visual acuity of better than 20/200, it is associated with a risk of implant failure. In cases of failure, a repeat B-KPro may offer another opportunity for vision restoration. This study aims to evaluate the long-term outcomes of patients undergoing repeat B-KPro after failure of the initial implant.
Design: This is a retrospective cohort study.
Participants: Eighteen patients who underwent two B-KPro implantations in the same eye, with a mean follow-up period of 8.1 ± 4.6 years.
Methods: The primary endpoints were the failure rate of the implant and visual acuity at the last follow-up.
Results: The failure rate of the repeat B-KPro (11.11% at 5 years) was significantly lower than that of the first B-KPro (88.89% at 5 years) (p < 0.0001) for the repeat cohort. Visual acuity better than 20/200 was achieved in 30.09% and 24.07% of patients at 3 years and 6 years, respectively, following repeat B-KPro, similar to outcomes observed after the first B-KPro. The incidence of phthisis was higher after the repeat B-KPro, but the rates of hypotony, endophthalmitis, corneal melt, and extrusion were lower compared to the first B-KPro.
Conclusions: Repeat B-KPro can provide sustained visual acuity better than 20/200 after failure of the initial implant. Further studies with larger cohorts are needed to better understand the risks and benefits associated with repeat B-KPro.
期刊介绍:
Official journal of the Canadian Ophthalmological Society.
The Canadian Journal of Ophthalmology (CJO) is the official journal of the Canadian Ophthalmological Society and is committed to timely publication of original, peer-reviewed ophthalmology and vision science articles.