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Long-term outcomes of MICOF keratoprosthesis in the end stage of autoimmune dry eyes: an experience in China
  1. Yifei Huang1,
  2. Ying Dong2,
  3. Liqiang Wang1,
  4. Gaiping Du1,
  5. Jifeng Yu1,
  6. Jing Song1,
  7. Homer H Chiang3
  1. 1Department of Ophthalmology, Chinese PLA General Hospital, Beijing, China
  2. 2Department of Ophthalmology, First Hospital Affiliated to Chinese PLA General Hospital, Beijing, China
  3. 3Department of Anesthesiology, Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Professor Yifei Huang, Fuxing Road 28, Department of Ophthalmology, Chinese PLA General Hospital, 100853, Beijing, China; 301yk{at}sina.com

Abstract

Aims To evaluate the clinical outcomes following Moscow Eye Microsurgery Complex in Russia keratoprosthesis (MICOF KPro) implantation in end-stage autoimmune dry eyes.

Methods A retrospective observational case series. Fourteen patients with end-stage autoimmune dry eyes underwent MICOF KPro surgery by one surgeon (YH) in the Chinese PLA General Hospital between 2000 and 2009. Retention of the prosthesis and vision were recorded and postoperative complications were analysed.

Results Preoperative diagnosis included Stevens–Johnson syndrome (n=7), ocular cicatricial pemphigoid (n=4) and Sjogren's syndrome (n=3). The mean follow-up period was 3.9 years (range 10 months–7.8 years). After surgery, 13 eyes (93%) showed a visual acuity of 20/200 or better and 6 eyes (43%) achieved excellent vision of 20/40 or better. At last visit, 69% of the eyes (9/13) maintained a visual acuity of at least 20/200. The first case retained a visual acuity of 20/80 7.8 years after the operation. The most common complication was stromal melting that threatened anatomical success. Seven of the first eight patients showed tissue melting, and four of them had leakage. All of these were repaired successfully. The latter six cases received prophylactic autologous auricular cartilage implantation to reinforce the anterior surface of recipient's cornea at either stage 1 or 2. Other causes of vision loss included pre-existing glaucoma (n=6), sterile vitritis (n=5), cylinder loosening (n=1) and retroprosthetic membrane (n=4).

Conclusion MICOF KPro provided useful vision for the end stage of autoimmune dry eyes in our study. Anatomical stability of KPro was achieved in all cases using repair and reinforcing surgery.

  • Ocular surface
  • cornea
  • inflammation
  • prosthesis
  • rehabilitation

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Footnotes

  • YH and YD have contributed equally to this work.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Chinese PLA General Hospital, China.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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