Purchase this article with an account.
L. A. Kim, M. Heur, J. Song, S. Yiu, F. Memarzadeh, A. A. Fawzi; Surgical Results of Combined Pars Plana Vitrectomy, Cornea Transplant, With or Without Glaucoma Surgery. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2569.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the results and complications of combined pars plana vitrectomy with or without temporary keratoprosthesis (PPV ± TKP), penetrating keratoplasty (PKP), with or without glaucoma tube shunt surgery.
Retrospective review of all cases of combined PPV/TKP/PKP and possible tube shunt surgery of a single surgeon (AAF) identified a total of 10 eyes from 10 patients (6/2006 - 11/2009) We evaluated the indications as well as the complications of the combined surgery.
Mean age of the patients was 66.1 ± 12.9 years. 4 eyes presented with preoperative retinal pathology. 4 eyes had previous corneal grafts and had graft failure. Six eyes were pseudophakic, 2 patients were aphakic, and only 2 eyes were phakic. Indications for surgery include corneal opacification with combined retinal detachment or uncontrolled glaucoma. 5 patients had undergone previous failed glaucoma surgery, and 4 had undergone previous retinal surgery. Preoperative visual acuity ranged from hand motion to counting fingers vision. Mean preoperative intraocular pressure was 22.1 ± 15.2 mm Hg (range 5 - 50 mm Hg). Mean postoperative intraocular pressure was 12 ± 7 mm Hg (range 4 - 29 mm Hg). A temporary keratoprosthesis was used in 8 out of 10 combined operations. All patients underwent PPV and PKP, and 6 patients had glaucoma tube shunts placed or revised. Additional lens surgery was performed in 7 patients, including removal of intraocular lenses, sutured IOLs, and removal of the crystalline lens. Postoperatively, 5 patients had improvement of vision and 1 patient had a decrease in vision, while the other 4 had no improvement in vision (range HM to 20/100 vision). Postoperative complications included shallow anterior chamber (2 eyes); choroidal detachment (1 eye); elevated intraocular pressure (1 eye); hyphema (1 eye).
The present study suggests that despite the presumed poor prognosis of eyes necessitating combined posterior and anterior segment surgeries, there is a relatively high success rate of combined retinal, corneal, and glaucoma surgery. Half of the eyes experienced an improvement of visual acuity. Furthermore, postoperative intraocular pressures improved significantly in all eyes with a mean improvement of 10.1 mm Hg (paired t-test, P-value = 0.0427).
This PDF is available to Subscribers Only