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A safe Nd:YAG retroprosthetic membrane removal technique for keratoprosthesis
Garrick Chak1, James V Aquavella
1Flaum Eye Institute, University of Rochester School of Medicine & Dentistry, Rochester, NY 14642, USA. gchak@stanfordalumni.org
Purpose:
To describe a technique for Nd:YAG laser photodiscission of retroprosthetic membrane (RPM) in keratoprosthesis patients that minimizes damage to the optic.
Methods:
Prospective review of Boston type I keratoprosthesis patients at 1 site who received Nd:YAG treatment for RPM from 2005 to 2009. Outcomes were based on slit-lamp examination of the optic immediately after YAG treatment, tactile intraocular pressure at follow-up, and complications from the outpatient procedure.
Results:
The incidence of RPM was 24.1% (39 of 162 eyes). Of 26 RPM eyes receiving YAG treatment, 18 had 1 YAG treatment, 6 had multiple YAG treatments, and 2 had surgical excision despite multiple YAG treatments because of membrane thickness. All 26 eyes had no intraoperative complications, no damage to the optic from slit-lamp examination, and soft tactile intraocular pressures.
Conclusion:
Based on the office procedures from our patient base, YAG retroprosthetic membranectomy using a peripheral "can-opener" approach is effective and safe with no evident damage to the optic.
