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S.B. Hannush, F. Badala; Management of Glaucoma with the Boston Keratoprosthesis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3944.
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To evaluate the need for glaucoma tube shunt placement to control intraocular pressure in patients receiving the Boston I Keratoprosthesis.
Sixteen patients undergoing Boston I permanent keratoprosthesis placement (failed graft 12, chemical injury 2, aniridia 2) between January 2003 and September 2005 were evaluated for the need for glaucoma tube shunt placement before or at the time of surgery. Thirteen patients received tube shunts. Three patients had intraocular pressures in the low teens on no glaucoma medication and did not receive the tube shunt.
All thirteen keratoprosthesis patients who received tube shunts before or at the time of surgery mantained good intraocular pressure control during the postoperative period (1–34 months). The three patients who did not receive tube shunts eventually developed intractable glaucoma not responsive to maximal medical therapy. They required tube shunt placement secondarily.
It appears that all patients receiving the Boston I permanent keratoprosthesis should have glaucoma tube shunt devices placed before or at the time of surgery to mantain adequate intraocular pressure control.
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