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Lindsay Machen, Andrea Carolina Arteaga, Felix Yan-Fay Chau, Ahmad A Aref, Thasarat S Vajaranant, Maria Soledad Cortina; Incidence of Retinal Complications in Patients with Combined Keratoprosthesis and Glaucoma Drainage Device Surgery. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5689. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Many patients diagnosed with conditions necessitating keratoprosthesis (Kpro) implantation suffer from concurrent glaucoma, either as a result of the underlying ocular pathology or as a complication from the Kpro device and procedure. Due to the significant challenge in monitoring and treating glaucoma following Kpro placement, combination Kpro and glaucoma drainage device (GDD) surgery has become the standard for many institutions. Safety and long-term complications of the combined procedure remains contested. We aimed to assess the incidence of retinal complications in patients treated with Kpro alone vs. concurrent Kpro and GDD insertion via pars plana approach.
We performed a retrospective chart review of 94 patients treated with Kpro implants at the University of Illinois at Chicago from 2007 to 2015. After excluding 29 eyes with prior vitrectomy, a total of 65 eyes were included in the analysis. Main outcomes included one-year incidence of post-operative retinal complications including retinal detachment (RD), endophthalmitis, cystoid macular edema (CME) and epiretinal membrane (ERM). A chi square test was used to compare the rates of retinal complications between the two groups.
Of the 65 eyes, 27 had Kpro with concurrent pars plana GDD insertion vs. 38 with Kpro alone. In the GDD group, 59% (16/27) experienced a retinal complication as compared to 55% (21/38) of the control group; comparison of complication rates via Chi-square test yielded a P-value of 0.749. Retinal complications in the GDD group included six RD, three endophthalmitis, eight CME, and four ERM. The control group featured 10 RD, nine endophthalmitis, 17 CME, and 13 ERM.
Initial results suggest no statistically significant difference in retinal complications for those with Kpro alone vs. Kpro and pars plana tube placement, however further risk stratified analysis is necessary to better define the safety of Kpro and concurrent GDD surgical intervention in order to provide a solid treatment recommendation.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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