Keratoprosthesis in China

Abstract

We read with great interest and appreciation the paper “Clinical Characteristics and Visual Outcome of Severe Ocular Chemical Injuries in Shanghai” by Hong et al1Hong J. Qiu T. Wei A. et al.Clinical characteristics and visual outcome of severe ocular chemical injuries in Shanghai.Ophthalmology. 2010; 117: 2268-2272Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar on the outcomes of their hard work. They conclude that severe ocular chemical injury in the Shanghai area were seen mainly in young men working in industry or construction. The injury usually occurred at the workplace, and the majority of injuries were caused by alkali agents. They also indicated that there was little information available about the prognosis of severe ocular chemical injury. Only 5 eyes (2.1%) recovered to a visual acuity 6/60. Two hundred twenty-one eyes (92.5%) were considered to be visually impaired. In our 9-year study of Moscow Eye Microsurgery Complex keratoprosthesis (MICOF) in Beijing, chemical burns were the underlying diagnosis for more than half of the total patients (58.8%, 50/85). The preoperative best corrected visual acuity (BCVA) of all patients ranged from count finger to light perception. However, postoperative BCVA was 20/100 or better in 80.7% (67/83) at 6 months, 82.4% (61/74) at 1 year, and 72.7% (40/55) at 2 years.2Huang Y. Yu J. Liu L. et al.Moscow eye microsurgery complex in Russia keratoprosthesis in Beijing.Ophthalmology. 2011; 118: 41-46Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar We concluded that use of the MICOF keratoprosthesis was an effective and promising approach for patients with chemical burns. It should be considered in instances of poor prognosis for penetrating keratoplasty (PK). Up to now, a total of more than100 MICOF cases have been performed in our hospital, which comprise more than 95% of the keratoprosthesis surgeries in China as far as we know. As the authors described, the estimated prevalence rate in Shanghai of severe ocular chemical injury was 1.58 per 100 000. Most of these patients are young, healthy, and potentially productive were it not for their corneal diseases which typically feature severe neovascularization with a poor prognosis for PK. These patients not only see poorly but also struggle with the profound psychological, social, and economic repercussions of their blindness. Use of a keratoprosthesis might be the last option for these kinds of patients with corneal blindness induced by chemical burns to regain sight. We strongly agree the authors' opinion on that most patients lacked education on the awareness of the dangerous properties of the acid and alkali agents and the correct methods of handling chemicals and first aid measures. Government should establish a comprehensive education program to reduce the risk of occupation-related ocular chemical burns. Clinical Characteristics and Visual Outcome of Severe Ocular Chemical Injuries in ShanghaiOphthalmologyVol. 117Issue 12PreviewTo study the clinical characteristics of patients with severe ocular chemical injury in Shanghai and to determine their relationship with visual outcome. Full-Text PDF Author replyOphthalmologyVol. 118Issue 7PreviewWe appreciate the comments expressed by Dr. Ji-Feng Yu and Dr. Yi-Fei Huang regarding our manuscript1 and thank them for providing first-hand information based on their experience with the Moscow Eye Microsurgery Complex keratoprosthesis (MICOF).2 Full-Text PDF