Abstract
Abstract: :
Purpose: Severe corneal opacity can prevent adequate visualisation of the posterior segment for vitreoretinal surgery. We report our experience in such patients who have undergone combined closed vitreoretinal surgery and penetrating keratoplasty with the Eckardt temporary keratoprosthesis. Methods: Retrospective casenote analysis was performed. Results: 10 eyes in 10 patients underwent penetrating keratoplasty after closed vitreoretinal surgery under the Eckardt temporary keratoprosthesis. The patients ranged in age from 31 to 74 years (mean 48y), 6 of whom were male. Corneal opacity was secondary to trauma in 7 patients, with previous microbial keratitis in 3. Proliferative vitreoretinopathy was present in all cases, following previous traumatic or rhegmatogenous retinal detachment. Snellen visual acuity improved by 2 lines in 3 patients, remained unchanged in 4 and worsened in 3 cases. The corneal graft failed within 3 months of surgery in 4 cases and at 18 months postoperatively. The retina remained flat in all but 2 cases, which required further surgery. The mean follow-up period was 18 months (range 6 to 30 months) with a final best corrected visual acuity of 6/60 or better in 6 eyes. Conclusion: The Eckardt temporary keratoprosthesis can be successfully used for vitreoretinal surgery in combination with penetrating keratoplasty, although the visual prognosis in such patients may be poor due to longstanding retinal pathology and possibly reduced corneal graft survival.
Keywords: 451 keratoprostheses • 628 vitreoretinal surgery • 369 cornea: clinical science