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Glaucoma associated with keratoprosthesis

P A Netland1, H Terada, C H Dohlman

  • 1Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA.

Ophthalmology
|April 17, 1998
PubMed
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Glaucoma is common after keratoprosthesis surgery for severe corneal disease. Glaucoma drainage implants effectively control intraocular pressure (IOP) in most patients, improving vision outcomes.

Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Glaucoma Management

Background:

  • Severe corneal disease often necessitates keratoprosthesis implantation.
  • Glaucoma is a frequent complication following keratoprosthesis surgery, impacting visual prognosis.
  • Managing intraocular pressure (IOP) is critical for preserving vision in these complex cases.

Purpose of the Study:

  • To review clinical experience with glaucoma in patients receiving keratoprostheses.
  • To evaluate the efficacy and outcomes of glaucoma drainage devices in this patient population.

Main Methods:

  • Retrospective case series review of 55 eyes in 52 patients with keratoprostheses.
  • Analysis of 36 eyes that underwent glaucoma drainage device implantation (Ahmed or Krupin valves).

Related Experiment Videos

  • Assessment of vision, IOP, visual fields, optic disc appearance, and complications.

    • Main Results:

    • Glaucoma affected 64% of eyes with keratoprostheses (36% pre-existing, 28% post-operative).
    • IOP was controlled in 81% of eyes with glaucoma drainage devices, though 25% required additional medications.
    • Vision improved in 63% of eyes post-keratoprosthesis surgery; glaucoma drainage implants had a low rate of non-vision-threatening complications.

    Conclusions:

    • Elevated IOP is a significant challenge in keratoprosthesis patients.
    • Glaucoma drainage implants represent an effective strategy for IOP control and visual preservation.
    • Early intervention and appropriate management are crucial for optimizing outcomes in keratoprosthesis-associated glaucoma.