July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Combined corneal transplant, glaucoma drainage implantation and pars-plana vitrectomy outcomes in a pediatric population
Author Affiliations & Notes
  • Kelley Bohm
    Ophthalmology, Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Alvaro Fernandez-Vega
    Ophthalmology, Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Joel Sugar
    Ophthalmology, Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Elmer Tu
    Ophthalmology, Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Aisha Traish
    Ophthalmology, John H. Stroger Hospital of Cook County, Chicago, Illinois, United States
  • Jose de la Cruz
    Ophthalmology, Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Ahmad Aref
    Ophthalmology, Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Thasarat S Vajaranant
    Ophthalmology, Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Felix Chau
    Ophthalmology, Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Jennifer I Lim
    Ophthalmology, Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Yannek Leiderman
    Ophthalmology, Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Robison Vernon Paul Chan
    Ophthalmology, Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Maria Soledad Cortina
    Ophthalmology, Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Kelley Bohm, None; Alvaro Fernandez-Vega, None; Joel Sugar, None; Elmer Tu, None; Aisha Traish, None; Jose de la Cruz, None; Ahmad Aref, None; Thasarat Vajaranant, None; Felix Chau, None; Jennifer Lim, None; Yannek Leiderman, None; Robison Chan, None; Maria Cortina, None
  • Footnotes
    Support  1. P30 EY001792; 2. Unrestricted Departmental Grant from Research to Prevent Blindness (RPB)
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 1574. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Kelley Bohm, Alvaro Fernandez-Vega, Joel Sugar, Elmer Tu, Aisha Traish, Jose de la Cruz, Ahmad Aref, Thasarat S Vajaranant, Felix Chau, Jennifer I Lim, Yannek Leiderman, Robison Vernon Paul Chan, Maria Soledad Cortina; Combined corneal transplant, glaucoma drainage implantation and pars-plana vitrectomy outcomes in a pediatric population. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1574.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose : The combination of glaucoma drainage device (GDI), pars-plana vitrectomy (PPV) and corneal transplantation is well reported in adults. However, little is known about the outcomes of such combined procedures in pediatric patients. Here we present a retrospective, single center, observational clinical study to evaluate the safety and clinical outcomes of concurrent GDI and or PPV with corneal transplantation procedures in patients 18 years and younger.

Methods : We retrospectively examined the medical records of 41 pediatric patients (ages 0-18 years) who received either corneal transplants or keratoptosthesis (KPro) in combination with at least one additional procedure (either GDI and/or PPV) at the Illinois Eye and Ear Infirmary, Chicago, IL (2003-2017). Primary outcomes included vision, intraocular pressure (IOP), and cup-to-disc ratio (C/D). Secondary outcomes included number of repeat surgeries, intraoperative and postoperative complications.

Results : Forty-one were included in the study with mean age of 8.8 years and average follow-up duration of 61.3 months. Eighteen patients received corneal surgery, GDI, and PPV; 5 received corneal and GDI surgery; 18 received corneal and PPV surgery. Comparing the final visits (mean 56.4 months post-operative) to the pre-operative visits in the patients with all three surgeries, 60% patients experienced an increase in vision with an average improvement of 2.9 lines. Average IOP decrease was -13.37, and C/D increased by 0.11. Eighty-three percent of patients had at least one subsequent surgery, with an average of 2.8 surgeries (0.83 cornea, 0.89 glaucoma, 1.06 retina) following their initial combined procedures. Seventy-two percent of patients experienced complications, including GDI exposure/extrusion, retinal detachments, Kpro extrusion, and corneal graft opacification.

Conclusions : Combined keratoplasty, GDI and PPV appears to be effective in the management of complex pediatric eye disease. Following combined cornea, glaucoma, and retina procedures, vision and IOP improved while C/D slightly worsened. However, the majority of patients had at least one surgical complication and needed at least one additional surgery. Because of the high risk of complications in this vulnerable patient population, careful consideration must be taken when determining a patient’s surgical candidacy for combined cornea/glaucoma/retina procedures.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×