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Visual Outcomes After Temporary Keratoprosthesis Kristin C. Bains, MD Robert Phillips, MD The authors have no financial interest in the subject matter of this poster. Purpose.
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Visual Outcomes After Temporary KeratoprosthesisKristin C. Bains, MDRobert Phillips, MDThe authors have no financial interest in the subject matter of this poster
Purpose To evaluate visual outcomes after combined penetrating keratoplasty (PK) and vitreoretinal surgery using temporary keratoprosthesis (TKP)
Introduction • Utilized in patients with coexisting corneal and vitreoretinal pathology • Combined procedure necessary for adequate visualization intraoperatively • If combined only with PK, delay waiting for graft to clear, leading to worsening retinal pathology • Does not expose patient to risks associated with open-sky vitrectomy • Attempts to restore visual function by allowing earlier surgical intervention
Methods IRB approval obtained Retrospective, observational case series CPT code 65770 Date range: 2003-2010 55 eyes of 47 patients identified 1 corneal surgeon, multiple vitreoretinal surgeons Included: 47 eyes of 41 patients who underwent combined TKP/PK and vitreoretinal surgery Excluded: 8 eyes of 6 patients lost to follow-up Previous surgeries common
Methods Wide-field Landers TKP Vitreoretinal procedures 3 port ppv Pars plana lensectomy if indicated Retinal reattachment Penetrating keratoplasty
Results Follow-up: 1 month- 67 months Mean pt follow-up: 23.4 months Post-operative graft status at final follow-up 17 clear (36.9%) 29 rejected 7 repeat TKP/PK 5 repeat PK
Conclusions Before combined surgery 21 eyes had BCVA of ambulatory to HM. Post-operatively, majority of patients (32 eyes) had BCVA of ambulatory to HM. 93.6% of eyes (44 eyes) were retained 2.1% of eyes (1 eye) became phthisical
Conclusion Tool used in management of complex disease, without which, many eyes could not be salvaged Combined surgery is not without complications Outcomes can be good considering complexity of pathology