Glaucoma management in patients with osteo-odonto-keratoprosthesis (OOKP): the Singapore OOKP Study.
OBJECTIVE
To report diagnostic modalities and treatment options for glaucoma in eyes with osteo-odonto keratoprosthesis (OOKP).


METHODS
Eyes that underwent OOKP were evaluated for glaucoma at the time of the first postoperative visit, then at 1 and 3 months after the procedure, and thereafter every 6 months. All eyes underwent stereo-biomicroscopic optic nerve head (ONH) assessment, kinetic (Goldmann perimetry) and automated static visual field testing, ONH photography, Heidelberg retina tomograph, scanning laser polarimetery (GDx), and optical coherence tomography. Treatment of glaucoma was also reviewed.


RESULTS
Average follow-up period was 19.1 (range: 5 to 31) months. Of the 15 eyes that underwent OOKP, 5 eyes had preexisting glaucoma. None of the other 10 eyes developed glaucoma after OOKP. ONH photography and visual field testing were the most reliable methods to assess status of the disease, whereas Heidelberg retina tomograph and optical coherence tomography could be performed with reasonable reproducibility and quality; GDx imaging was poor. All patients with glaucoma were treated with oral acetazolamide 500 mg twice a day. Transscleral cyclophotocoagulation was performed in 3 eyes at stage 2 of OOKP surgery. Progression of glaucoma was noted in 2 eyes on the basis of optic disc photographs and automated perimetry.


CONCLUSIONS
Visual field testing and optic disc assessment with optic disc photographs seem to be effective methods to monitor eyes with OOKP for glaucoma. Treatment strategies include oral medications to lower intraocular pressure and cyclophotocoagulation.
Kumar
Rajesh S
RS
Singapore Eye Research Institute, National University of Singapore, Singapore.
Tan
Donald T H
DT
Por
Yong-Ming
YM
Oen
Francis T
FT
Hoh
Sek-Tien
ST
Parthasarathy
Anand
A
Aung
Tin
T
D000086:Acetazolamide / Q000008:administration & dosage; D000284:Administration, Oral; D000328:Adult; D001705:Bioprosthesis / Q000009:adverse effects*; D001766:Blindness / Q000601:surgery*; D003315:Cornea / Q000601:surgery*; D003941:Diagnostic Techniques, Ophthalmological; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008028:Light Coagulation / Q000379:methods; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000473:pathology; D010781:Photography; D019919:Prosthesis Implantation / Q000009:adverse effects*; D012160:Retina / Q000473:pathology; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests; D055815:Young Adult
D000086:Acetazolamide