Session Title: Vitreoretinal Surgery IV
Session Date/Time: Sunday 20/09/2015 | 09:00-10:30
Paper Time: 09:48
First Author: : M.Tyagi INDIA
Co Author(s): : R. Reddy Pappuru Y. Rohit S. Basu V. Sangwan
PURPOSE:To evaluate the incidence, time of occurrence and management of posterior segment complications after Boston type I keratoprosthesis implantation
Retrospective chart review of all operated cases of Boston type 1 keratoprosthesis at single tertiary eye care centre in South India
Medical records were reviewed of Eighty eight eyes of 86 patients who underwent Boston type 1 keratoprosthesis(kpro) surgery between January 2000 to July 2014. Baseline demographic characteristics, postoperative posterior segment complications, and final visual acuity outcomes were analyzed. Only those participants who had completed at least six months follow up post vitreo-retinal interventions were included in analysis The primary outcome measures were incidence of postoperative posterior segment complications and visual acuity outcomes.
Boston type 1 keratoprosthesis was implanted in 88 eyes of 86 patients (Age range: 1 month-77 years, mean age: 34.9 years). 72/86 patients (83.7%) were males . All participants completed at least 6 months of follow up post keratoprosthesis as well as post vitreo-retinal interventions. Most common posterior segment complication was development of a retroprosthetic membrane which was seen in 32.9% (n=29) eyes . Other complications included retinal detachment in 14.7% (n=14), vitreous haemorrhage in 14.7%(n=13) eyes, endophthalmitis 10.2% (n=9), and epiretinal membrane in 5.6% eyes (n=5). Suture less pars plana vitrectomy with or without silicone oil injection was performed in 23 eyes , membranectomy in 6 eyes and Yag capsulotomy in 11 eyes respectively. After vitrectomy for retinal detachment, 57.1 %( 8/14) of all eyes had BCVA of +1.00LogMar (snellens equivalent of 20/200) or better at last follow up. 6 out of 9 eyes developing endophthalmitis had a poor outcome inspite of surgical intervention and ended up with NPL vision
Posterior segment complications are seen in a significant percentage of patients after Boston keratoprosthesis surgery, resulting in a significant reduction of visual acuity in a good proportion of the affected eyes.