Vitreoretinal complications of osteoodontokeratoprosthesis surgery.
OBJECTIVE
To describe the vitreoretinal complications in a cohort of patients with osteoodontokeratoprosthesis (OOKP) and discuss surgical management.


METHODS
Review of notes of 35 OOKP cases performed at the Sussex Eye Hospital (Brighton, United Kingdom) between January 1999 and December 2005 was performed.


RESULTS
The overall incidence of vitreoretinal complications was 22.8%, which included vitreous hemorrhage (3 patients), rhegmatogenous retinal detachment (3 patients), endophthalmitis with retinal detachment complicating lamina resorption and optic extrusion (2 patients), and intraoperative choroidal hemorrhage (1 patient). Preexisting aphakia was associated with rhegmatogenous retinal detachment (P < 0.05, chi2 = 4.36). Five patients required pars plana vitrectomy, which was performed either endoscopically (two cases) or using a binocular indirect viewing system (three cases) with one case requiring removal of the OOKP and insertion of a temporary keratoprosthesis. Retinal detachment repair was attempted on four of five patients but was successful for only one. Vitreous hemorrhage without retinal detachment required vitrectomy in one case, while two cases cleared spontaneously.


CONCLUSIONS
Eyes receiving OOKP are prone to vitreoretinal complications, with retinal detachment associated with a poor prognosis. Thicker OOKP laminae and lamina bulk screening will hopefully reduce the risk of endophthalmitis due to unexpected resorption.
Hughes
Edward H
EH
Sussex Eye Hospital, Brighton, United Kingdom.
Mokete
Bataung
B
Ainsworth
Gerard
G
Casswell
Anthony G
AG
Eckstein
Michael B
MB
Zambarakji
Hadi J
HJ
Gregor
Zdenek
Z
Rosen
Paul H
PH
Herold
Jim
J
Okera
Salim
S
Liu
Christopher S C
CS
D002610:Cheek; D002832:Choroid Hemorrhage / Q000209:etiology; D015331:Cohort Studies; D003315:Cornea / Q000601:surgery*; D020878:Device Removal; D009877:Endophthalmitis / Q000209:etiology; D004724:Endoscopy; D005128:Eye Diseases / Q000209:etiology* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects; D019736:Prostheses and Implants; D012086:Reoperation; D012163:Retinal Detachment / Q000209:etiology; D012164:Retinal Diseases / Q000209:etiology; D012167:Retinal Perforations / Q000209:etiology; D012189:Retrospective Studies; D012599:Sclerostomy; D014092:Tooth Root / Q000637:transplantation*; D014821:Vitrectomy; D014822:Vitreous Body; D014823:Vitreous Hemorrhage / Q000209:etiology