title: Permanent keratoprosthesis combined with pars plana vitrectomy and silicone oil injection for visual rehabilitation of chronic hypotony and corneal opacity.
abstract: 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.
authors.affiliation: Division of Cornea and External Disease, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Canan Asli
authors.initials: CA
authors.lastname: Utine
authors.forename: Peter L
authors.initials: PL
authors.lastname: Gehlbach
authors.forename: Ingrid
authors.initials: I
authors.lastname: Zimmer-Galler
authors.forename: Esen K
authors.initials: EK
authors.lastname: Akpek
mesh_terms: 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
chemical_list: D012827:Silicone Oils