title: Challenges in the implantation of a Boston type 1 keratoprosthesis and a glaucoma drainage device in a nanophthalmic eye.
abstract: A 67-year-old man presented with hand motions vision, a decompensated vascularised cornea and a flat anterior chamber in the right eye 5 years following cataract and glaucoma surgery. He lost the left eye several years ago following a similar intervention. The intraocular pressure (IOP) was 19 mm Hg on four antiglaucoma medications and the axial length was 19 mm. In view of the high risk for graft failure, a Boston type 1 keratoprosthesis (Kpro) was planned for visual rehabilitation, and a glaucoma drainage device (GDD) for IOP control. Although a combined GDD with Kpro was indicated, we performed sequential surgeries to avoid vision threatening hypotony-related complications. He underwent parsplana vitrectomy, prophylactic lamellar sclerectomies and Kpro at the first stage, followed by a paediatric Ahmed glaucoma valve implantation 3 months later. Despite precautions, postoperative uveal effusion occurred but could be managed conservatively. His IOP was controlled; visual acuity improved to 20/50 and remained stable at 2 years.
authors.affiliation: Department of Glaucoma, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India.
authors.forename: Sirisha
authors.initials: S
authors.lastname: Senthil
authors.affiliation: Department of Glaucoma, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India.
authors.forename: Kiranmaye
authors.initials: K
authors.lastname: Turaga
authors.affiliation: Department of Glaucoma, Sankara Nethralaya, Kolkata, West Bengal, India.
authors.forename: Ravi
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Cornea and Anterior Segment Service, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India.
authors.forename: Virender S
authors.initials: VS
authors.lastname: Sangwan
mesh_terms: D000368:Aged; D003316:Corneal Diseases / Q000150:complications / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D005901:Glaucoma / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D008297:Male; D008850:Microphthalmos / Q000150:complications*