April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Glaucoma Management In Patients Undergoing Boston Type I Keratoprosthesis Implantation
Author Affiliations & Notes
  • Jennifer S. Huang
    Ophthalmology, Jules Stein Eye Institute, Los Angeles, California
  • Simon K. Law
    Ophthalmology, Jules Stein Eye Institute, Los Angeles, California
  • Fei Yu
    Ophthalmology, Jules Stein Eye Institute, Los Angeles, California
  • JoAnn A. Giaconi
    Ophthalmology, Jules Stein Eye Institute, Los Angeles, California
  • Anne L. Coleman
    Ophthalmology, Jules Stein Eye Institute, Los Angeles, California
  • Joseph Caprioli
    Ophthalmology, Jules Stein Eye Institute, Los Angeles, California
  • Anthony J. Aldave
    Ophthalmology, Jules Stein Eye Institute, Los Angeles, California
  • Footnotes
    Commercial Relationships  Jennifer S. Huang, None; Simon K. Law, None; Fei Yu, None; JoAnn A. Giaconi, None; Anne L. Coleman, None; Joseph Caprioli, None; Anthony J. Aldave, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 2627. doi:
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      Jennifer S. Huang, Simon K. Law, Fei Yu, JoAnn A. Giaconi, Anne L. Coleman, Joseph Caprioli, Anthony J. Aldave; Glaucoma Management In Patients Undergoing Boston Type I Keratoprosthesis Implantation. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2627.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To evaluate intraocular pressure (IOP) control in patients undergoing Boston type I keratoprosthesis (kpro) with concurrent placement of a glaucoma drainage device (GDD).

Methods: : A consecutive case series of kpro procedures performed by a single surgeon (AJA) between May 2004 and Oct 2010 was analyzed. Eyes with preoperative IOP<21mmHg (IOP-controlled) and preoperative IOP≥21mmHg (IOP-uncontrolled) were evaluated separately. Outcome measures included elevated IOP (defined as ≥25mmHg) and need for additional medical or surgical glaucoma management after kpro surgery.

Results: : 90 primary kpro procedures were performed in 90 eyes of 86 patients. Mean follow-up was 18.7 and 15.5 months in the IOP-controlled (58 eyes) and IOP-uncontrolled (32 eyes) groups, respectively (p=0.37). In the IOP-controlled group, 11 eyes (19%) had concurrent GDD placement at the time of kpro surgery. Nine % (1/11) of these eyes developed elevated IOP after kpro surgery compared to 15% (7/47) of eyes without concurrent GDD placement (p=1.00). Additional glaucoma medications were required after kpro implantation in 27% (3/11) and 23% (11/47) of eyes with and without concurrent GDD placement, respectively (p=1.00). Additional glaucoma surgery was not performed during follow-up in any eyes with GDD placement at the time of kpro surgery, but was required in 4% (2/47) of eyes without concurrent GDD placement (p=1.00).In the IOP-uncontrolled group, 25 eyes (78%) underwent GDD placement at the time of kpro surgery. Twenty four % (6/25) of these eyes developed elevated IOP after kpro surgery compared to 29% (2/7) of eyes without concurrent GDD placement (p=1.00). Additional glaucoma medications were required after kpro implantation in 28% (7/25) and 71% (5/7) of eyes with and without concurrent GDD placement, respectively (p=0.07). Additional glaucoma surgery was not performed during follow-up in any eyes with GDD placement at the time of kpro surgery, but was required in 14% (1/7) of eyes without concurrent GDD placement (p=0.22).

Conclusions: : GDD placement at the time of kpro surgery was not associated with a significant decrease in the percentage of eyes that developed elevated IOP after kpro surgery. The percentage of eyes that required additional postoperative medical glaucoma management was reduced with concurrent GDD placement in eyes with preoperative IOP≥21mmHg. No eyes with concurrent GDD placement required additional glaucoma surgery following kpro implantation.

Keywords: keratoprostheses • intraocular pressure • clinical (human) or epidemiologic studies: outcomes/complications 
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