Ziya Kapran*, Yaprak Banu Ünver, Nur Acar, Yapar Küçüksümer (Istanbul, Turkey)

Advantages:

To evaluate surgical outcomes using a temporary intraoperative keratoprosthesis (KP) in patients undergoing combined pars plana vitrectomy (PPV) and penetrating keratoplasty (PKP).

Methods:

We retrospectively reviewed chart of patients in whom a temporary keratoprosthesis was used between 2001and 2011. Only patients with more than 6 months follow-up were included. Patents characteristics, diagnosis, visual acuity (VA), intraocular pressure, and status retina and corneal at baseline, postoperative on one week, months 1,3, 6 and yearly until last follow-up, were collected. Functional and anatomic outcomes were analysis prior to review.

Effectiveness / Safety:

A temporary keratoprosthesis was used in 8 eyes, 5 (62.5%) of which were for trauma-related indications. Retinal detachments were present in all eyes; most had evident proliferative vitreoretinopathy. Preoperative diagnoses were vitreous hemorrhage in one (12.5%) eye, vitreous hemorrhage in (12.5%) eye, postoperative endophthalmitis in two (25%) eyes. Improvement in VA was seen in 6 (75%) maintained equal or better at their final visit as compared with before surgery. Retinal reattachment was achieved in all eyes, and no eyes had phthisis. The common documented reasons for poor final VA were optic atrophy or macular scar (25%). Corneal grafts remained clear in 7 (87.5 %) cases. Two patients had further surgery.

Take home message:

Temporary KP during PPV/PKP surgery allowed surgical intervention in eyes with complex anterior and posterior segment disease. Corneal graft clarity and successful retinal reattachment was possible in majority of eyes.