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1、AssessingtheRoleofSoftContactLensesin…：评价软性角膜接触镜的作用…Thekeratoprosthesis(Kpro),anartificialcornea,hasproveneffectiveatestablishingaclearpathwayforlightthroughanopaquecornea.1Toqualifyfortheprocedure,patientswhounderwentKProsurgeryhadpoorprognosesforsimplepenetratingk
2、eratoplasty.Theseincludedpatientswithmultiplegraftrejection(54%),chemicalinjury(15%),andherpessimplexviruskeratitis(7%)amongothers.2Thequalityoflifeofthepatientswasincreasedwiththerestorationofvision,insomecasesfromlightperceptiononlyto20/400vision1.INTRODUCTONSomeo
3、fthedifficultiesarisingfromtheKProsurgeryhavebeendesiccationbyevaporativeforces,epithelialdefects,stromalthinning,anddellenformation.3ProblemscausedbythephysicalpresenceofthedeviceincludeinstabilityoftheKProandaqueoushumorleakage.4Tohelpprotectthecorneafromsomeofthe
4、secomplications,asoftcontactlens(SCL)isroutinelyplacedasthelaststepofsurgery.3ThelensprotectsthecornealsurfacebydiffusingtheevaporativeforcesandmaintainingafluidmeniscusattheedgeofthefrontplateoftheKPro.Italsocorrectspostoperativerefractiveerror,andcanbeusedforcosme
5、ticeffecttomatchitspairedeye.3,5,6Photos:KeratoprosthesiswithoverlyingsoftcontactlensonslitlampexamChemicalinjuryhadmoreSCLlosseswhileautoimmunehadfewest.Asmallsubset(n=17)ofthepopulationexperiencedmorethan2SCLlossesperyear.Thesepatientscomprised6%oftheautoimmunegro
6、up,22%ofthechemicalinjurygroup,and21%ofthe“other”group.Figure:Numberofsoftcontactlens(SCL)lossesper10yearsSCLwear.Autoimmuneexperiencedthehighestyearlycomplicationrateand“other”thelowestrate.Amongallthreecategories,complicationrateswerehighestwhenpatientswerenotwear
7、ingtheircontactlenses.Themostcommoncomplicationexperiencedwascornealmeltresultinginaqueoushumorleak.Patientsovertheageof70yearsweresignificantlylesslikelytoexperienceacomplicationcomparedtothoseyoungerthan70.Figure:NumberofcomplicationsexperiencedwhilewearingSCLandw
8、ithoutSCLper10patient-yearsoffollow-up.Evenwithatrendtowardhigherlensretention,somepatientswithautoimmunediseasearedestinedtodevelopcornea
