Glaucoma associated with keratoprosthesis.
OBJECTIVE
This study aimed to review the authors clinical experience with glaucoma associated with keratoprosthesis in patients with severe corneal disease.


METHODS
The study design was a retrospective review of case series.


METHODS
The authors studied 55 eyes in 52 patients with keratoprostheses with follow-up of 21 +/- 16 months (range, 3-77 months).


METHODS
Glaucoma drainage devices were implanted in 36 eyes (35 Ahmed valves, 1 Krupin valve) with 21 +/- 15 months' follow-up (range, 3-64 months).


METHODS
Clinical outcome assessment included vision, intraocular pressure (IOP), visual fields, optic disc appearance, and identification of complications.


RESULTS
Glaucoma was found in the majority (64%) of eyes treated with keratoprostheses, identified in 20 eyes (36%) before surgery and an additional 15 eyes (28%) after surgery. Of the 36 eyes treated with glaucoma drainage devices, IOP was controlled in 29 eyes (81%), with 9 eyes (25%) requiring additional medications. Continued progression of glaucoma occurred in 5 (14%) of 36 eyes with keratoprostheses and glaucoma drainage implants (4 of these eyes had advanced glaucomatous optic nerve damage before surgery). There were nine nonvision-threatening complications due to drainage implants. Compared with the preoperative visual acuity, vision was markedly improved in 63%, unchanged in 17%, and worse in 20% of eyes after keratoprosthesis surgery.


CONCLUSIONS
Elevation of IOP is common in patients with keratoprosthesis, and prevention or treatment with glaucoma drainage implants is effective.
Netland
P A
PA
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA.
Terada
H
H
Dohlman
C H
CH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003315:Cornea / Q000601:surgery*; D003316:Corneal Diseases / Q000601:surgery*; D004322:Drainage / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019736:Prostheses and Implants / Q000009:adverse effects*; D012189:Retrospective Studies; D014792:Visual Acuity; D014794:Visual Fields