波士顿1型角膜假体植入术后视网膜脱离的风险：来自回顾性病例回顾的见解。

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-09-05 DOI:10.1016/j.ajo.2025.09.007

Simon Elsliger , Maya Sebag , Wissam B Nassrallah , Moncef Berkache , Allison Bernstein , Dominique Geoffrion , Rayan Tolba , Amir Abd Elkader , Mona Harissi-Dagher

{"title":"波士顿1型角膜假体植入术后视网膜脱离的风险：来自回顾性病例回顾的见解。","authors":"Simon Elsliger , Maya Sebag , Wissam B Nassrallah , Moncef Berkache , Allison Bernstein , Dominique Geoffrion , Rayan Tolba , Amir Abd Elkader , Mona Harissi-Dagher","doi":"10.1016/j.ajo.2025.09.007","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the incidence, risk factors, management strategies, and visual outcomes of retinal detachment (RD) following Boston Keratoprosthesis Type 1 (KPro) implantation.</div></div><div><h3>Design</h3><div>Single-center, retrospective observational case series.</div></div><div><h3>Methods</h3><div>Medical records of 157 eyes from 122 adult patients who underwent Boston Type 1 KPro implantation at a tertiary care center between 2008 and 2022 were reviewed. Inclusion criteria included age ≥18 years and postoperative follow-up of at least 1 year. Demographic data, preoperative characteristics, postoperative complications, and visual outcomes were collected. Univariate and multivariate statistical analyses were conducted to identify significant risk factors for RD. Cox regression and Kaplan–Meier survival analysis were used to evaluate time-to-event data.</div></div><div><h3>Results</h3><div>Of the 157 eyes that underwent Boston Type 1 KPro implantation, 27 eyes (17.2%) developed retinal detachment (RD), all within 8 years postoperatively (2 RD per 100 eye years). Aniridia was significantly associated with increased RD risk (OR: 2.79; 95% CI: 1.23-6.70), while other preoperative diagnoses were not. Eyes with RD were more likely to experience hypotony (OR: 7.63; <em>P</em> < .0001), choroidal detachment (OR: 7.67; <em>P</em> < .0001), phthisis (OR: 7.69; <em>P</em> < .0001), and other serious complications. Surgical intervention was possible in 16 of the 27 RD cases, with pneumatic retinopexy being the most common approach.</div></div><div><h3>Conclusions</h3><div>Retinal detachment is a significant complication following KPro implantation, particularly in patients with aniridia. Postoperative hypotony and other inflammatory complications may contribute to increased RD risk and challenge surgical repair. Close monitoring of high-risk patients may help mitigate long-term visual morbidity.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"281 ","pages":"Pages 1-9"},"PeriodicalIF":4.2000,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Risk of Retinal Detachment Following Boston Keratoprosthesis Type 1 Implantation: Insights From a Retrospective Case Review\",\"authors\":\"Simon Elsliger , Maya Sebag , Wissam B Nassrallah , Moncef Berkache , Allison Bernstein , Dominique Geoffrion , Rayan Tolba , Amir Abd Elkader , Mona Harissi-Dagher\",\"doi\":\"10.1016/j.ajo.2025.09.007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>To evaluate the incidence, risk factors, management strategies, and visual outcomes of retinal detachment (RD) following Boston Keratoprosthesis Type 1 (KPro) implantation.</div></div><div><h3>Design</h3><div>Single-center, retrospective observational case series.</div></div><div><h3>Methods</h3><div>Medical records of 157 eyes from 122 adult patients who underwent Boston Type 1 KPro implantation at a tertiary care center between 2008 and 2022 were reviewed. Inclusion criteria included age ≥18 years and postoperative follow-up of at least 1 year. Demographic data, preoperative characteristics, postoperative complications, and visual outcomes were collected. Univariate and multivariate statistical analyses were conducted to identify significant risk factors for RD. Cox regression and Kaplan–Meier survival analysis were used to evaluate time-to-event data.</div></div><div><h3>Results</h3><div>Of the 157 eyes that underwent Boston Type 1 KPro implantation, 27 eyes (17.2%) developed retinal detachment (RD), all within 8 years postoperatively (2 RD per 100 eye years). Aniridia was significantly associated with increased RD risk (OR: 2.79; 95% CI: 1.23-6.70), while other preoperative diagnoses were not. Eyes with RD were more likely to experience hypotony (OR: 7.63; <em>P</em> < .0001), choroidal detachment (OR: 7.67; <em>P</em> < .0001), phthisis (OR: 7.69; <em>P</em> < .0001), and other serious complications. Surgical intervention was possible in 16 of the 27 RD cases, with pneumatic retinopexy being the most common approach.</div></div><div><h3>Conclusions</h3><div>Retinal detachment is a significant complication following KPro implantation, particularly in patients with aniridia. Postoperative hypotony and other inflammatory complications may contribute to increased RD risk and challenge surgical repair. Close monitoring of high-risk patients may help mitigate long-term visual morbidity.</div></div>\",\"PeriodicalId\":7568,\"journal\":{\"name\":\"American Journal of Ophthalmology\",\"volume\":\"281 \",\"pages\":\"Pages 1-9\"},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2025-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Ophthalmology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0002939425004787\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0002939425004787","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的评价1型波士顿角膜假体（KPro）植入术后视网膜脱离（RD）的发生率、危险因素、治疗策略和视力结果。设计：单中心、回顾性观察病例系列。方法回顾性分析2008年至2022年在某三级医疗中心接受波士顿1型KPro植入术的122例成人患者157只眼的医疗记录。纳入标准为年龄≥18岁，术后随访至少1年。收集人口统计学资料、术前特征、术后并发症和视力结果。进行单因素和多因素统计分析以确定RD的显著危险因素。Cox回归和Kaplan-Meier生存分析用于评估事件发生时间数据。结果157只眼行Boston 1型KPro植入术，27只眼（17.2%）发生视网膜脱离（RD），均在术后8年内发生（每100眼年2例RD）。无虹膜与RD风险增加显著相关（OR: 2.79; 95% CI: 1.23-6.70），而其他术前诊断则无显著相关性。RD的眼睛更容易出现低斜视（OR: 7.63; p<0.0001）、脉络膜脱离（OR: 7.67; p<0.0001）、溃疡（OR: 7.69; p<0.0001）和其他严重并发症。27例RD病例中有16例可以进行手术治疗，其中充气视网膜固定术是最常见的方法。结论视网膜脱离是KPro植入术后的重要并发症，尤其是无虹膜患者。术后低斜视和其他炎症并发症可能增加RD风险，并对手术修复造成挑战。密切监测高危患者可能有助于减轻长期的视力发病率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

The Risk of Retinal Detachment Following Boston Keratoprosthesis Type 1 Implantation: Insights From a Retrospective Case Review

Purpose

To evaluate the incidence, risk factors, management strategies, and visual outcomes of retinal detachment (RD) following Boston Keratoprosthesis Type 1 (KPro) implantation.

Design

Single-center, retrospective observational case series.

Methods

Medical records of 157 eyes from 122 adult patients who underwent Boston Type 1 KPro implantation at a tertiary care center between 2008 and 2022 were reviewed. Inclusion criteria included age ≥18 years and postoperative follow-up of at least 1 year. Demographic data, preoperative characteristics, postoperative complications, and visual outcomes were collected. Univariate and multivariate statistical analyses were conducted to identify significant risk factors for RD. Cox regression and Kaplan–Meier survival analysis were used to evaluate time-to-event data.

Results

Of the 157 eyes that underwent Boston Type 1 KPro implantation, 27 eyes (17.2%) developed retinal detachment (RD), all within 8 years postoperatively (2 RD per 100 eye years). Aniridia was significantly associated with increased RD risk (OR: 2.79; 95% CI: 1.23-6.70), while other preoperative diagnoses were not. Eyes with RD were more likely to experience hypotony (OR: 7.63; P < .0001), choroidal detachment (OR: 7.67; P < .0001), phthisis (OR: 7.69; P < .0001), and other serious complications. Surgical intervention was possible in 16 of the 27 RD cases, with pneumatic retinopexy being the most common approach.

Conclusions

Retinal detachment is a significant complication following KPro implantation, particularly in patients with aniridia. Postoperative hypotony and other inflammatory complications may contribute to increased RD risk and challenge surgical repair. Close monitoring of high-risk patients may help mitigate long-term visual morbidity.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.