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Mohamed Abou Shousha, Zachary Schmitz, Joshua Abernathy, Ross Chod, Zachary Bodnar, Rocio Bentivegna, Sean Edelstein, Levent Akduman; Pars Plana Vitrectomy and Silicone Oil insertion Protect Against Endophthalmitis in Patients with Boston Type 1 Keratoprosthesis. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1118.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate visual outcomes and postoperative complication rates in eyes with Boston type 1 keratoprosthesis combined with pars plana vitrectomy and silicone oil insertion (KPro+PPV+SOI) as compared to eyes receiving Boston type 1 keratoprosthesis (KPro) alone.
Retrospective case control study of 24 eyes with Boston type 1 keratoprosthesis. Ten of these eyes had hypotony and/or retinal detachment in addition to corneal pathology, and thus received KPro implantation combined with pars plana vitrectomy and silicone oil insertion. Outcome measures included best-corrected visual acuity (BCVA) and rates of post-operative complications including endophthalmitis, KPro extrusion, retinal detachment, newly developed glaucoma and retroprosthetic membrane (RPM) recorded at 1, 3, 6 and 12 months follow-up visits
In the KPro+PPV+SOI group, no eyes had developed endophthalmitis by the 12 month follow-up visit. On the other hand, 5 eyes in the uncombined KPro group developed endophthalmitis (P<0.05). Four of these 5 eyes had vitreous taps with positive bacterial cultures. Other complications included Kpro extrusion (1 in each group), retinal detachment (1 in each group), newly developed glaucoma (2 in the KPro group) and RPM (6 in KPro and 4 in KPro+PPV+SOI group). The KPro group had better average preoperative and 1st month postoperative BCVA as compared to those of the Kpro+PPV+SIO group (1/200 vs. HM; P=0.01 and 20/300 vs. 3/200; P=0.03, respectively). No statistically significant difference in BCVA was noted in subsequent follow-up visits.
Boston type 1 Keratoprosthesis combined with pars plana vitrectomy and silicone oil insertion in eyes with corneal pathology as well as hypotony and/or retinal detachment is a safe and effective procedure for visual rehabilitation. Furthermore, pars plana vitrectomy and silicone oil insertion may have a protective effect against the development of postoperative endophthalmitis in eyes receiving the Boston Type 1 Keratoprosthesis.
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