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Gerardo Garcia-Aguirre, Alejandro Dalma-Kende, Jose Dalma-Weiszhausz; Use of Temporary Keratoprosthesis with Wide-Angle Viewing System for Posterior Segment Trauma. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2602.
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To describe the use of a temporary keratoprosthesis (modified from the Landers-Foulk temporary keratoprosthesis) along with a wide-field viewing system in posterior segment trauma.
Retrospective review of patients with posterior segment trauma that required vitreoretinal surgery, with corneal opacities that precluded adequate visualization. Patients underwent temporary keratoprosthesis using a modification of the Landers-Foulk model, which has six fixation orifices, and which measures 11 mm of anterior width, 7.2 mm of posterior width, and 0.7 mm height in its posterior aspect. After fixation of the keratoprosthesis, patients underwent vitrectomy using a wide-field viewing system (either EIBOS or AVI). After the vitreoretinal procedure was finished, a corneal graft was sutured with 10-0 nylon. Patients were followed-up at day 1, 7, 14, 30, 60, 90, and 180.
Four eyes of four patients were included. Preoperative visual acuity was light perception in two eyes, and hand motion in two eyes. All eyes had vitreous hemorrhage, and three had rhegmatogenous retinal detachment. In these three eyes, scleral buckling was performed. No adverse events were observed when fixating the prosthesis. Visualization of the posterior segment during surgery was excellent, reaching the far periphery. Visual acuity at month 6 ranged from 20/40 to hand motion.
The use of the modified Landers-Foulk keratoprosthesis along with a wide-field viewing system allows for excellent visualization of the posterior segment during vitreoretinal surgery in trauma cases.
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