Clinical Results with the Use of a Temporary Keratoprosthesis in Combined Penetrating Keratoplasty and Vitreoretinal Surgery

• Published in: European journal of ophthalmology 2010-09, Vol.20 (5), p.885-891
• Main Authors: Khouri, Albert S., Vaccaro, Anzhelica, Zarbin, Marco A., Chu, David S.
• Format: Article
• Language: English
• ISSN: 1120-6721; 1724-6016
• DOI: 10.1177/112067211002000512

Purpose To evaluate surgical outcomes using a temporary intraoperative keratoprosthesis (KP) in patients undergoing combined pars plana vitrectomy (PPV) and penetrating keratoplasty (PKP). Methods From January 2001 to August 2008, medical records of 23 patients undergoing combined KP/PPV/PKP for traumatic and nontraumatic corneal and retinal pathologies were studied. Only patients with ≥6 months follow-up were included. Patient characteristics, diagnoses, visual acuity, intraocular pressure, and status of the retina and cornea at baseline, and postoperatively on day 1, months 1 and 6, and yearly until the last follow-up, were collected. Functional (best-corrected visual acuity: improved, stable, worsened) and anatomic outcomes (clear corneal graft, retinal reattachment) were defined prior to review. Results Twenty-four eyes underwent combined KP/PPV/PKP (mean follow-up 36 months). At final follow-up, best-corrected visual acuity improved in 8 (40%) eyes, remained stable in 8 (40%), and worsened in 4 (20%). Corneal graft was clear in 18(79%) eyes; 5(21%) had graft failure. Retinal reattachment occurred in 22 (92%) eyes; 2 (8%) developed a localized traction retinal detachment not warranting additional surgery. Derangement in intraocular pressure was common (13 [54%] eyes). Three eyes (13%) showed signs of phthisis preoperatively that resolved with reestablishment of normal intraocular pressure postoperatively. Conclusions Temporary KP during PPV/PKP surgery allowed surgical intervention in eyes with complex anterior and posterior segment disease. Corneal graft clarity and successful retinal reattachment was possible in the majority of eyes.