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Abstract #5482 Published in IGR 1-2

Clinical study of combined penetrating keratoplasty, pars plana vitrectomy with temporary keratoprosthesis, and pars plana seton implant.

Johnston RH; Nguyen R; Jongsareejit A; Lee BR; Patel S; Chong LP
Retina (Philadelphia, Pa.) 1999; 19: 116-121


PURPOSE: To assess the effectiveness of a combined procedure (pars plana vitrectomy with temporary keratoprosthesis, penetrating keratoplasty, and pars plana seton implant) in preserving vision and controlling intraocular pressure (IOP). METHODS: We reviewed the course of visual acuity, IOP, graft clarity, retinal status, and complications in 18 patients who underwent the above procedure during one operating sitting. RESULTS: Preoperative diagnoses were varied. The majority of patients had pseudophakic bullous keratopathy and failed corneal transplants with glaucoma. Preoperative mean visual acuity was hand motions. Preoperative mean IOP was 27±13 mmHg. Initially, all patients had attached retina. With a mean follow-up of 17±9 months, six patients had improved vision greater than 2 lines and 10 had unchanged vision. Only two patients lost vision greater than 2 lines. The final average IOP was 16±6 mmHg and only one eye had a pressure above 22 mmHg. Three eyes were classified as complete failures; two of the three became phthisical. Two patients developed rhegmatogenous detachments requiring further surgery. CONCLUSION: The combined procedure offers reasonable improvement in vision, good pressure control, and a tolerable number of complications. It is a useful procedure in eyes that probably would not have been treatable otherwise.

Doheny Eye Institute, Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles, USA.


Classification:

12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)



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