Clinical Study
Eye (2006) 20, 59–63. doi:10.1038/sj.eye.6701794; published online 28 January 2005
Long-term outcome of combined penetrating keratoplasty and vitreoretinal surgery using temporary keratoprosthesis
X Dong1, W Wang1, L Xie1 and A M-C Chiu1
1Shandong Eye Institute & Hospital, Qingdao, China
Correspondence: L Xie, Shandong Eye Institute & Hospital, 5 Yanerdao Road, Qingdao 266071, China. Tel: +86 532 588 5195; Fax: +86 532 588 1212; E-mail: lixinxie@public.qd.sd.cn
Received 20 June 2004; Revised 1 November 2004; Accepted 1 November 2004; Published online 28 January 2005.
Abstract
Purpose
To evaluate the long-term outcome of combined penetrating keratoplasty (PKP) and vitreoretinal surgery using temporary keratoprosthesis (TKP).
Methods
A retrospective study of 107 eyes with coexisting corneal and vitreoretinal diseases that underwent combined PKP and vitreoretinal surgery using TKP. Corneal graft clarity, intraocular pressure, and anatomical reattachment of retina were followed.
Results
The mean follow-up time was 25 months, the longest being 8 years. Successful surgical outcome was defined as maintenance of clear graft, anatomic reattachment of retina, and controlled intraocular pressure. A total of 78 eyes (72.9%) fulfilled these criteria. Surgical intervention within 1 month of ocular injury was associated with higher success rate (81.9%) than intervention at 1 month or more after injury (54.3%). Success rate for reattachment of retina was 95.8% when preoperative proliferative vitreoretinal retinopathy (PVR) was absent compared with 83.1% when preoperative PVR was present. Unsatisfactory postoperative visual acuity was due to graft failure, recurrent PVR, or secondary glaucoma.
Conclusion
Combined PKP and vitreoretinal surgery is best performed within 1 month of ocular injury for best surgical outcome. Careful selection of cases plays an important role in reducing the risks of complications. TKP is a useful adjunct in the surgery.
Keywords:
temporary keratoprosthesis, penetrating keratoplasty, vitrectomy, long-term outcome
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