Purchase this article with an account.
Grace L. Kim, Abbas Haider, Zina Zhang, Sameh Mosaed; Impact of Glaucoma Intervention in Patients Undergoing Boston Type 1 Keratoprosthesis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6501.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Managing glaucoma is challenging in Boston Type 1 Keratoprosthesis (KPro) patients, but it is imperative as the incidence as well as rate of progression are high in this cohort. In a retrospective study, we evaluated the impact of surgical glaucoma intervention in patients who either underwent concurrent or had prior glaucoma surgery 6 months prior to reiceivng KPro versus glaucoma surgery 6 months after receiving KPro.
In a retrospective cohort study, we analyzed 34 eyes in 22 patients that underwent KPro implantation from 2003 to 2009 at a single tertiary care institution. All patients who received KPro were included, and patients who no did not have measurements of their glaucoma status such as Humphrey Visual Field test or view of optic nerve at any point were exluded.The cases were analyzed in 2 groups based on timing of surgical glaucoma intervention. Group 1 consisted of 12 individuals who at the time of KPro implantation either underwent concurrent glaucoma surgery, or had a history of glaucoma surgery 6 months prior to the KPro surgery. Group 2 included 10 individuals who were glaucoma surgery naive patients at the time of KPro surgery and either did not need glaucoma surgery or underwent glaucoma surgery within 6 months of the KPro surgery.Categorical variables were expressed as frequencies and percentages, and comparisons were perfomed using the Pearson chi-square test. Continuous variables were presented as mean and standard deviations. All statitical tests were done using 2-tailed, and statistical significance considered using a P value less than 0.05.
Preliminary data suggests that early glaucoma intervention prevents glaucomatous damage as measured by peripheral vision loss or glaucomatous optic nerve changes on clinical examination as compared to late intervention once glaucoma is already detected in this patient population. Many subjects in this cohort are approaching the 5 year follow-up period, and all data will be updated and re-analyzed at this critical follow-up interval.
Glaucoma management for patients undergoing keratoprosthesis surgery is challenging due to difficulty of visualization of the optic nerve and reliable intraocular pressure measurement. Concurrent or pre-emptive glaucoma surgical intervention at time KPro surgery should be considered in order to prevent or limit postoperative visual loss due to glaucoma development or progression.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
This PDF is available to Subscribers Only