title: Vitreoretinal complications and vitreoretinal surgery in osteo-odonto-keratoprosthesis surgery.
abstract: OBJECTIVE
  To describe the indications for and approaches to vitreoretinal surgery in patients with osteo-odonto-keratoprosthesis (OOKP).
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  This was a retrospective review of all patients who had undergone OOKP surgery between 2003 and 2012 at our center. OOKP procedures were performed for severe ocular surface disease according to the indications and techniques described in the patient demographics of the Rome-Vienna Protocol. Indications for retinal surgery, surgical outcomes, and intraoperative and postoperative complications were documented. Operative techniques were reviewed from the surgical records, and any subsequent surgeries were also recorded.
  
  
  RESULTS
  Thirty-six patients underwent OOKP, and retinal surgery was indicated in 13 (36%). The indications for and approaches to surgery were retinal detachment repair using an Eckardt temporary keratoprosthesis; assessment of retina and optic nerve health prior to OOKP surgery, using either a temporary keratoprosthesis or an endoscope; endoscopic cyclophotocoagulation for intractable glaucoma; endoscopic trimming of a retroprosthetic membrane; or vitrectomy for endophthalmitis with visualization through the OOKP optic using the binocular indirect viewing system. In all cases, retinal surgical aims were achieved with a single procedure. Postoperative vitreous hemorrhage occurred in 16 patients (44%), but all resolved spontaneously.
  
  
  CONCLUSIONS
  OOKPs represent the last hope for restoration of vision in severe ocular surface disease, and the retinal surgeon is frequently called upon in the assessment and management of these patients. Temporary keratoprostheses and endoscopic vitrectomies are valuable surgical tools in these challenging cases, improving functional outcomes without compromising OOKP success.
authors: Singapore National Eye Centre; Singapore Eye Research Institute.
authors: Laurence S
authors: LS
authors: Lim
authors: Singapore National Eye Centre; Singapore Eye Research Institute.
authors: Chong Lye
authors: CL
authors: Ang
authors: Singapore National Eye Centre; Singapore Eye Research Institute.
authors: Edmund
authors: E
authors: Wong
authors: Singapore National Eye Centre; Singapore Eye Research Institute.
authors: Doric W K
authors: DW
authors: Wong
authors: Singapore National Eye Centre; Singapore Eye Research Institute; Department of Ophthalmology, National University of Singapore. Electronic address: snecdt@pacific.net.sg.
authors: Donald T H
authors: DT
authors: Tan
mesh_terms: D000539:Alveolar Process / Q000637:transplantation*; D003316:Corneal Diseases / Q000601:surgery*; D009877:Endophthalmitis / Q000209:etiology / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications; D011183:Postoperative Complications; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery; D012166:Retinal Hemorrhage / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D014092:Tooth Root / Q000637:transplantation*; D016896:Treatment Outcome; D014821:Vitrectomy; D057586:Vitreoretinal Surgery