Permanent keratoprosthesis combined with pars plana vitrectomy and silicone oil injection for visual rehabilitation of chronic hypotony and corneal opacity.
OBJECTIVE
To present outcomes of combined pars plana vitrectomy, silicone oil (SO) injection, and permanent keratoprosthesis (Kpro) procedure in prephthisical eyes.


METHODS
All 3 patients were monocular with chronic severe hypotony, aphakia, and total corneal opacity in their vital eye. Preoperative visual acuity ranged from light perception to counting fingers at 1 foot. Two patients had a history of failed corneal grafts because of SO, and one had funnel retinal detachment. Pars plana vitrectomy and long-term SO tamponade were performed, and a permanent Boston type 1 Kpro was used in lieu of a donor corneal transplantation.


RESULTS
No unexpected intraoperative complications were encountered. Patients were followed for a period of 11-13 months. All patients had anatomic success with an attached retina and a clear visual axis. The procedures resulted in increased visual function in all patients ranging from hand motions to 20/800. No case has progressed to phthisis bulbi during the follow-up period. At the last visit, biomicroscopic examination revealed clear Kpro with an attached retina.


CONCLUSIONS
Boston type 1 Kpro implantation, as the primary corneal procedure with pars plana vitrectomy and intraocular SO, may be a viable option in selected patients with prephthisical eyes.
Utine
Canan Asli
CA
Division of Cornea and External Disease, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Gehlbach
Peter L
PL
Zimmer-Galler
Ingrid
I
Akpek
Esen K
EK
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003318:Corneal Opacity / Q000534:rehabilitation*; D006801:Humans; D007429:Intraocular Pressure; D058449:Intravitreal Injections; D008297:Male; D015814:Ocular Hypotension / Q000534:rehabilitation*; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012827:Silicone Oils / Q000008:administration & dosage*; D016896:Treatment Outcome; D014786:Vision Disorders / Q000534:rehabilitation*; D015349:Vision, Monocular; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
D012827:Silicone Oils