title: Complications associated with Boston keratoprosthesis type 1 and glaucoma drainage devices.
abstract: OBJECTIVE
  To compare the complications leading to best-corrected visual acuity (BCVA) loss in patients with Boston keratoprosthesis type 1 (KPro) and glaucoma drainage device (GDD) and those with KPro alone.
  
  
  METHODS
  Retrospective case series of all patients who underwent KPro surgery at the Centre Hospitalier de l'Université de Montréal between 2008 and 2011. Preoperative diagnoses, BCVA and complications were tabulated and analysed.
  
  
  RESULTS
  KPro surgery was performed in 96 eyes: 18 eyes (19%) had KPro and GDD while 78 eyes (81%) had KPro only. Median BCVA at postoperative 6 months was 20/150 in both groups. Seven eyes (39%) with KPro and GDD experienced vision loss due to complications such as glaucoma progression (three eyes, 22%), tube occlusion (four eyes, 22%) and choroidal haemorrhage (three eyes, 17%). Vitreous incarceration was the most common cause of tube occlusion. Vitreoretinal, glaucoma and infectious complications caused BCVA loss in 16 eyes (21%) with KPro alone (p=0.13).
  
  
  CONCLUSIONS
  Glaucoma progression is a major cause of visual decline post-KPro. However, GDD implantation should only be performed in carefully selected patients. Because of a high risk of vitreous incarceration within the tube, a complete pars plana vitrectomy should be performed prior to GDD implantation.
authors: Department of Ophthalmology, Notre-Dame Hospital, 1560, Sherbrooke East, Montreal, Quebec, Canada H2L 4M1. marie-claude.robert.2@umontreal.ca
authors: Marie-Claude
authors: MC
authors: Robert
authors: Valérie
authors: V
authors: Pomerleau
authors: Mona
authors: M
authors: Harissi-Dagher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001187:Artificial Organs / Q000009:adverse effects*; D003315:Cornea; D018450:Disease Progression; D005260:Female; D005901:Glaucoma / Q000175:diagnosis / Q000601:surgery; D020327:Glaucoma Drainage Implants / Q000009:adverse effects*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension; D011183:Postoperative Complications; D019736:Prostheses and Implants / Q000009:adverse effects*; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D014786:Vision Disorders / Q000209:etiology*; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult