中文摘要：

目的 评价复杂性角膜混昆浊患者行Boston Ⅰ型人工角膜植入术的临床效果和并发症.方法 回顾性系列病例研究.收集2009年5月至2013年10月在解放军总医院眼科接受Boston Ⅰ型人工角膜植入术的患者57例（61只眼）.其中化学伤19例,热烧伤17例,爆炸伤6例,角膜炎8例,自身免疫2例,角膜内皮失代偿9例.人工角膜植入术按照美国麻省眼耳鼻喉医院标准化手术方式,并常规行晶状体切除.术后至少随访观察2个月,平均随访时间（19±9）个月（2～ 27个月）,并记录其视力及并发症情况.结果 术前患者视力均为光感、手动或指数,术后47只眼（77.0％）视力在0.1或以上,其中18只眼（29.5％）术后最好矫正视力高于0.3.术后出现载体角膜溶解10只眼（16.4％）,人工角膜后膜6只眼（9.8％）,青光眼12只眼（19.7％）,视网膜脱离2只眼（3.3％）,脉络膜脱离1只眼（1.6％）,眼内炎2只眼（3.3％）.并发症采取对症处理,除青光眼患者及2例眼内炎患者,所有患者视力可以维持原最好矫正视力.结论 Boston Ⅰ型人工角膜适用于穿透性角膜移植难于成功的患者,特别适合用于多次角膜移植失败患者,对于角膜严重血管化患者是有效的复明手段.术后长期密切随访以及正确处理相关并发症是保证长期维持较好效果的必要保证.

英文摘要：

Objective This study was to evaluate clinical results and complications associated with the Boston type Ⅰ keratoprosthesis implanted into complex corneal opacity.Methods Retrospective study.Sixty-one eyes （57 cases） received Boston type Ⅰ KPro implantation between May 2011 and January 2013 in the Chinese PLA General Hospital,and were followed for at least 2 months （range,2 to 27 months,mean 19 months）.Indications for keratoprosthesis included thermal injury （n=17）,chemical injury （n=19）,herpetic keratitis （n=8）,blast injury （n=6）,keratitis（n=8）,antoimmune diseases （n=2） and corneal endothelial decompensation （n=9）.Kpro implantation in accordance with the Massachusetts Eye Center standardized surgical approach,and routine lens removal meantime.Clinical complications and postoperative treatments were recorded.Results Preoperative visual acuity were light perception to the counting figure in all the patients.Forty-seven eyes （77%） had better best correct visual acurity than counting figure and 18 eyes （30%） had BCVA better than 0.3 after implantation.Postoperative complications indluded carrier corneal melting （10 cases）,retroprothesis membrane （6 cases）,glaucoma （12 cases）,retinal detachment （2 cases）,choroidal detachment （1 case）,endophthalmitis （2 cases）.Complications take symptomatic treatment,in addition to glaucoma patients and two cases of endophthalmitis patients （Evisceration）,all patients can maintain the original best corrected visual acuity.Conclusions Timely examination of the KPro and replacement with donor cornea may prevent a poor outcome.Close follow-up is necessary after KPro-implantation.