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Abstract #53055 Published in IGR 15-1
Complications associated with Boston keratoprosthesis type 1 and glaucoma drainage devices
Robert MC; Pomerleau V; Harissi-Dagher MBritish Journal of Ophthalmology 2013; 97: 573-577
BACKGROUND/AIMS: To compare the complications leading to best-corrected visual acuity (BCVA) loss in patients with Boston keratoprosthesis type 1 (KPro) and glaucoma drainage device (GDD) and those with KPro alone. METHODS: Retrospective case series of all patients who underwent KPro surgery at the Centre Hospitalier de l'Université de Montréal between 2008 and 2011. Preoperative diagnoses, BCVA and complications were tabulated and analysed. RESULTS: KPro surgery was performed in 96 eyes: 18 eyes (19%) had KPro and GDD while 78 eyes (81%) had KPro only. Median BCVA at postoperative 6 months was 20/150 in both groups. Seven eyes (39%) with KPro and GDD experienced vision loss due to complications such as glaucoma progression (three eyes, 22%), tube occlusion (four eyes, 22%) and choroidal haemorrhage (three eyes, 17%). Vitreous incarceration was the most common cause of tube occlusion. Vitreoretinal, glaucoma and infectious complications caused BCVA loss in 16 eyes (21%) with KPro alone (p=0.13). CONCLUSIONS: Glaucoma progression is a major cause of visual decline post-KPro. However, GDD implantation should only be performed in carefully selected patients. Because of a high risk of vitreous incarceration within the tube, a complete pars plana vitrectomy should be performed prior to GDD implantation.
Department of Ophthalmology, Notre-Dame Hospital, 1560, Sherbrooke East, Montreal, Quebec, Canada H2L 4M1. marie-claude.robert.2@umontreal.ca
Full articleClassification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
9.4.11.4 Glaucomas associated with corneal surgery (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)