Abstract
Purpose: :
To evaluate the efficacy of endocyclophotocoagulation (ECP) in patients with Boston Type 1 keratoprosthesis (BKPro I) when compared to glaucoma drainage devices (GDD).
Methods: :
Retrospective chart review of 28 eyes of 26 patients who underwent ECP or GDD placement at the time of BKPro I with a mean follow-up of 26.7 months (range of 1-76 months). GDD were implanted in 17 eyes (5 Ahmed, 12 Baerveldt) and ECP was performed in 11 eyes. Clinical outcome assessment included best corrected visual acuity, intraocular pressure (IOP), progression or development of glaucoma as assessed by optic disc appearance and visual fields, and postoperative complications.
Results: :
Ninety percent of the patients treated with ECP had a preoperative history of glaucoma prior to BKPro I surgery as compared to 64% of the eyes treated with a GDD. All eyes either developed glaucoma or had progression of glaucoma after BKPro I surgery. Of the 11 eyes treated with ECP, IOP was controlled in 7 eyes (63.63%) while 4 eyes required an additional glaucoma procedure. Of the 17 eyes treated with a GDD, IOP was controlled in 9 eyes (52.94%) and 8 eyes (47.06%) required an additional procedure. There was no difference between ECP and GDD treated groups postoperatively when comparing glaucoma progression (p=0.36) or intraocular pressure (p=0.93). Compared with preoperative visual acuity, vision improved in 64.29%, remained unchanged in 10.71%, and was worse in 25% of eyes after BKPro I surgery at last follow-up. There was no difference in visual acuity when comparing the ECP and GDD groups (p=0.51).
Conclusions: :
All patients undergoing BKPro I surgery had increased intraocular pressure. Management of elevated IOP with ECP is as effective as GDD after BKPro I.
Keywords: keratoprostheses • intraocular pressure