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Pablo Romero, Philip P Chen, Tueng T Shen, Mark A Slabaugh; Postoperative outcome in eyes with glaucoma treated with the Boston type I keratoprosthesis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6137.
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To evaluate patients with glaucoma after Boston type I keratoprosthesis implantation.
A retrospective chart review was conducted of Boston type I keratoprosthesis implanted by a single surgeon over a 6-year period in 25 eyes of 24 patients with severe ocular surface disease and glaucoma. Best-corrected visual acuity, postoperative complications and preoperative and postoperative glaucoma status were analyzed.
The mean age of patients was 58.9 years (range, 21-86 years). Visual acuity improved to 20/200 or better in 12 eyes (48%) and to 20/40 or better in 2 eyes (8%) after a mean follow-up period of 3.2 years after surgery. Glaucoma surgery was done in 5 eyes (20%) before keratoprosthesis surgery. In 11 eyes (44%) a tube was installed at the same time as the keratoprosthesis. Six months after keratoprosthesis ninety-two percent of the glaucoma patients did not have apparent worsening of the intraocular pressure. Two eyes (8%) required glaucoma surgery for worsening of glaucoma. The probability of increased number of glaucoma topical and oral medications after 3.8 years was 40% and 24%, respectively. Visual acuity worse than 20/200 occurred because of end-stage glaucoma in five patients (20%).
The difficulty of optic nerve evaluation due to corneal opacity prior to keratoprosthesis implantation prevented detection of end-stage glaucoma before surgery. Keratoprosthesis surgery did not appear to worsen the overall glaucoma status for the majority of the population studied.
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