[人造角膜:从开始到未来]。

Harefuah Pub Date : 2024-05-01
Olga Reitblat, Eitan Livny, Irit Bahar
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引用次数: 0

摘要

介绍:角膜疾病是导致全球失明的主要可逆原因之一。角膜移植是治疗大多数此类病例的成功治愈方法。然而,在某些适应症中,标准角膜移植并不适用,恢复功能性视力的唯一选择是角膜前列腺假体(KPro)植入术。由于全球供体角膜短缺,限制了角膜移植的机会,KPro 也可作为一种替代方案。然而,目前的 KPro 面临着许多挑战,包括手术的复杂性,需要熟练的外科医生和大量资源,以及独特的手术和术后并发症。尽管多年来提出了多种人造角膜,但目前临床上主要使用两种植入物。第一种是波士顿 KPro,它由一个带有光杆的前板和一个后板组成,前板和后板之间夹着供体角膜组织,然后将其缝合到患者的角膜上。第二种是Osteo-odonto-keratoprosthesis(OOKP),利用牙槽骨的生物组织来支撑眼球内的光学圆柱体。这两种手术的适应症、手术技术和并发症情况各不相同,本综述将对此进行讨论。广泛的研究仍在继续,以提高 KPros 的可及性和技术发展,从而为这些疑难病例的治疗寻求潜在的突破。
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[ARTIFICIAL CORNEA: FROM THE BEGINNING TO THE FUTURE].

Introduction: Corneal disease is among the leading reversible causes of blindness worldwide. Corneal transplantation is a successful and curative treatment for most of these cases. However, in certain indications it is not amendable for standard corneal transplantation, the only available option to restore functional vision is keratoprosthesis (KPro) implantation. KPros may also offer an alternative to the global shortage of donor corneas, limiting the access to transplantations. However, current KPros face many challenges, including surgical complexity that requires skilled surgeons and vast resources as well as unique surgical and post-operative complications. Although several artificial corneas have been proposed over the years, two implants are mostly used in the clinical setting today. The first, the Boston KPro, consists of a front plate with an optical stem and a back plate snapped together with donor corneal tissue in-between, which is then sutured to the patient's cornea. The second, the Osteo-odonto-keratoprosthesis (OOKP), uses biological tissue of the alveolar bone to support an optical cylinder within the eye. The indications, surgical techniques, and complication profile of the two procedures are different and will be discussed in this review. Extensive research continues to improve the accessibility and technological developments of KPros in the search for a potential breakthrough in the treatment of these difficult cases.

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