Clinical results in patients with combined penetrating keratoplasty and vitreoretinal surgery using landers wide-field temporary keratoprosthesis
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Date
2019
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Abstract
Objectives: To evaluate the clinical results of combined pars plana vitrectomy (PPV) with Landers wide-field temporary keratoprosthesis and penetrating keratoplasty (PK). Materials and Methods: From January 2016, traumatic eyes with coexisting corneal and vitreoretinal diseases that underwent combined keratoprosthesis/PPV/PK surgery were retrospectively evaluated. Demographic characteristics, visual acuity (VA), intraocular pressure (IOP) and clinical findings of the cornea, lens, and retina were recorded during the follow-up. Cases with clear corneal graft, attached retina, normotonic IOP, and improved or stable VA were considered successful. Results: Eight eyes were enrolled in the study. The mean follow-up time was 21.1±8.20 months. Surgery was performed a mean of 23 (10-40) days after trauma. Preoperative VA ranged from no light perception to counting fingers from 50 cm. Postoperatively, corneal graft was clear in 5 patients (62.5%) and retina was attached in 6 eyes (75%). Chronic hypotonia developed in 3 patients (37.5%). VA was unchanged in 3 patients and improved in 5 patients. A total of 5 cases (50%) were considered successful. Shorter interval between trauma and surgery was associated with higher likelihood of success (p=0.043). No significant difference was observed between the groups in terms of type or location of trauma (p=1; p=0.143). Conclusion: Although the functional results are not very satisfactory, the combined procedure provides a final opportunity for preserving remaining vision and anatomic reconstruction in eyes that will otherwise result in phthisis due to severe anterior and posterior segment pathologies. © 2019 by Turkish Ophthalmological Association.
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Adolescent , Adult , Eye Injuries, Penetrating , Female , Follow-Up Studies , Humans , Intraocular Pressure , Keratoplasty, Penetrating , Male , Middle Aged , Prostheses and Implants , Prosthesis Implantation , Retrospective Studies , Treatment Outcome , Visual Acuity , Vitrectomy , Young Adult , cyclopentolate , moxifloxacin , prednisolone acetate , sikloplejin , silicone , silicone oil , steroid , adolescent , adult , Article , clinical article , cornea opacity , cornea transplantation , cornea ulcer , cross-sectional study , female , graft failure , graft rejection , human , intraocular pressure , laser coagulation , low drug dose , male , oculoplethysmography , penetrating keratoplasty , perception , postoperative care , retrospective study , sclerotomy , visual acuity , vitrectomy , vitreoretinal surgery , eye injury , follow up , middle aged , pathophysiology , penetrating keratoplasty , physiology , procedures , prostheses and orthoses , prosthesis implantation , treatment outcome , visual acuity , young adult