Purpose
To evaluate visual outcomes and complications of pars plana vitrectomy (PPV) and silicone oil (SO) injection combined with Boston Type 1 Keratoprosthesis (BKP) implantation in eyes with retinal detachment (RD) and/or hypotony and corneal opacity.
Methods
Charts of 10 patients (11 eyes) were reviewed retrospectively. Outcome measures were best corrected visual acuity (BCVA), reported as logMAR visual acuity (LMVA), and complications. Postoperative visits were numbered based on a timeframe range: POV1 = day 1-2; POV2 = day 3-13; POV3 = week 2-6; POV4 = month 2-3; POV5 = month 4-5; POV6 = month 6-8.
Results
Mean post-op follow-up time for all patients was 6.93 months (range: 0.5-14.5 months). Mean BCVA at each post-op visit was significantly improved compared to the baseline mean. Preoperative mean-LMVA (LMVAm) = 3.30 (≤LP); POV1 LMVAm = 2.50 (CF<1ft; p=0.02); POV2 LMVAm = 1.96 (~2/200; p=0.015); POV3 LMVAm = 2.25 (CF>1ft; p=0.007); POV4 LMVAm = 2.40 (CF~1ft; p=.047); POV5 LMVAm = 2.05 (~2/200; p=0.003); POV6 LMVAm = 2.24 (CF>1ft; p=0.016).<br /> <br /> Retinal or optic nerve pathology was vision limiting in all patients. No patients suffered from endophthalmitis. Retroprosthetic membrane developed in 6 of 11 eyes (54%). One eye developed a wound leak requiring glue patch. One eye suffered from persistently elevated post-operative intraocular pressures requiring silicone oil evacuation. One eye suffered from post-operative rhegmatogenous RD. One eye suffered from recurrent anterior uveitis due to the underlying primary disease of uveitis, and required periocular triamcinolone injections.
Conclusions
Pars plana vitrectomy and silicone oil injection combined with Boston Type 1 Keratoprosthesis implantation in eyes with retinal detachment and/or hypotony and corneal opacity appears to improve vision with a reasonable complication profile.