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Long-term complications associated with glaucoma drainage devices and Boston keratoprosthesis.

Abstract：

PURPOSE:To evaluate long-term complications related to glaucoma drainage devices in patients undergoing Boston type 1 keratoprosthesis surgery. DESIGN:Retrospective case series. METHODS:All patients who underwent Boston type 1 keratoprosthesis surgery at the University of California, Davis, between 2004 and 2010 were included. Preoperative and postoperative data were reviewed. Twenty-five eyes with glaucoma drainage devices were highlighted. Visual acuity and postoperative complications were tracked at postoperative months 1, 3, 6, 9, and 12 and at annual intervals thereafter. RESULTS:Forty eyes of 35 patients were evaluated with an average follow-up of 33.6 months. Conjunctival breakdown occurred in association with 10 glaucoma drainage device implants in 9 eyes. Eleven eyes had glaucoma drainage devices placed before keratoprosthesis surgery, 3 eyes underwent glaucoma drainage device placement at the time of surgery, and 2 eyes had a glaucoma drainage device placed after surgery. All but one of the eroded glaucoma drainage devices were placed before surgery. Associated complications included endophthalmitis, hypotony, and keratoprosthesis extrusion, with 6 glaucoma drainage devices requiring removal. Long-term beset-corrected visual acuity was maintained better in eyes in which glaucoma drainage device erosions did not develop. CONCLUSIONS:One of the main challenges with keratoprosthesis surgery is treating concurrent glaucoma. Glaucoma drainage devices have been advocated as a way to address this long-term complication, but this series suggests that glaucoma drainage device-related complications can cause significant vision loss.

journal_name

Am J Ophthalmol

journal_title

American journal of ophthalmology

authors

Li JY,Greiner MA,Brandt JD,Lim MC,Mannis MJ

doi

10.1016/j.ajo.2011.01.034

subject

Has Abstract

pub_date

2011-08-01 00:00:00

pages

209-18

issue

2

eissn

0002-9394

issn

1879-1891

pii

S0002-9394(11)00072-9

journal_volume

152

pub_type

杂志文章

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