Cesare Forlini, Matteo Forlini, Adriana Bratu, Paolo Rossini (Ravenna, Italy)

Purpose:

To show the use of temporary keratoprosthesis (TKP, Landers) and of open sky surgery for the visualization of intraocular structures during pars plana vitrectomy in eyes with corneal and retinal pathologies and make possible to manage both in a single surgical procedure.

Methods:

We reviewed 35 eyes with combined anterior and posterior segment injuries necessitating the use of TKP and of open sky surgery for exploration and reconstruction. TKP was used intraoperatively to replace the opaque cornea. We use 25G anterior chamber infusion and mini-invasive 25/23G system. The corneal button was trephined followed by the anterior segment reconstruction and open sky vitrectomy. A TKP (7,2 mm or 8,2 mm) was placed allowing viewing of both the posterior pole and peripheral retina without/with contact lenses. The open sky surgery is useful to deal with anterior PVR. At the end extensive laser treatment was given in the periphery and silicone oil tamponade was performed. The TKP was removed and corneal graft was placed.

Results:

The functional improvement in these eyes is usually low; the use of TKP and open sky surgery in these cases gives a chance to the patients to obtain a useful visual acuity.

Conclusions:

The use of TKP and of open sky surgery allows performing the penetrating keratoplasty and the vitrectomy in the same surgical procedure and it is an important tool in this complex surgery.