The Boston Keratoprosthesis

摘要

Recently there have been many reports on the improvements and successes with the Boston Keratoprosthesis. The dedicated work of Dr. Claus Dohlman to create and refine this prosthesis has allowed for successful transplantation in patients in whom failure was previously certain. Personally, the results in the patients in whom I have performed this procedure have been miraculous. It has allowed that television-like moment of moving someone from blindness to sight. The first patient was a gentleman monocular from a previous trauma who developed a tumor which overtook his ocular surface in his remaining good eye. I initially performed a penetrating keratoplasty which failed given the total limbal stem cell deficiency. Following the keratoprosthesis, the patient has achieved 20/50 vision, and (more importantly) participates independently in his activities of daily living. A review of the literature from this year reveals studies about the usefulness of the keratoprosthesis in pediatric patients, those with aniridia, and individuals with herpetic keratitis. Despite the favorable outcomes, the ability to perform this surgery is in jeopardy because of new Medicare regulations.