Dealing with Corneal Opacity in Severe Endophthalmitis


Severe endophthalmitis with corneal opacity that was treated by combined penetrating keratoplasty using temporary keratoprosthesis and pars plana vitrectomy (PPV). The QPT, implemented after trepanation of the opaque cornea, vitreoretinal surgery allows a correct visualization of intraocular structures. Once the vitreo-retinal surgery has been completed, the keratoprosthesis is removed and placed suture and corneal graft. In this way you can perform both procedures in a single surgical time, optimizing maneuvers in the vitreous space. The indication of this complex procedure is any vitreoretinal pathology whose surgery can not be performed by corneal opacity which is not medically treatable and prevents sufficient preoperative visualization. The vast majority of candidates for this surgery are from ocular trauma but I will present these cases that had severe endophthalmitis with severe infection and corneal opacity not permitting vitreoretinal surgery without the use of keratoprostheses. Difficulty in inserting the trocar and and repeated episode of Globe collapse are common during vitrectomy using a temporary keratoptothesis. There may be a problem to use a contact wide angle viewing lens, due to leaking at the side of temporary keratoprosthesis, and poor visibility can hamper an optimal surgery. The functional and anatomical outcome in such cases remains poor despite recent advances in ophthalmic surgery. However, globe salvage rate of 38% has been reported in the literature using temporary KPro for endophthalmitis. Conclusion: In severe corneal haze with endophthalmitis involving the eye, surgery using temporary keratoprosthesis, vitrectomy and then corneal graft may be tried. This technique allows vitrectomy in a closed system. With the help of this technique eyes can be operated timely, which may save eyes from phythisis and blindness.


Susana Lucila Cura
CABA Buenos Aires, Argentina
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Cell Phone: +5491150120254
Work Phone: +5491150120254