Clinical results with the use of a temporary keratoprosthesis in combined penetrating keratoplasty and vitreoretinal surgery.

PURPOSE: To evaluate surgical outcomes using a temporary intraoperative keratoprosthesis (KP) in patients undergoing combined pars plana vitrectomy (PPV) and penetrating keratoplasty (PKP).

METHODS: From January 2001 to August 2008, medical records of 23 patients undergoing combined KP/PPV/PKP for traumatic and nontraumatic corneal and retinal pathologies were studied. Only patients with >or=6 months follow-up were included. Patient characteristics, diagnoses, visual acuity, intraocular pressure, and status of the retina and cornea at baseline, and postoperatively on day 1, months 1 and 6, and yearly until the last follow-up, were collected. Functional (best-corrected visual acuity: improved, stable, worsened) and anatomic outcomes (clear corneal graft, retinal reattachment) were defined prior to review.

RESULTS: Twenty-four eyes underwent combined KP/PPV/PKP (mean follow-up 36 months). At final follow-up, best-corrected visual acuity improved in 8 (40%) eyes, remained stable in 8 (40%), and worsened in 4 (20%). Corneal graft was clear in 18 (79%) eyes; 5 (21%) had graft failure. Retinal reattachment occurred in 22 (92%) eyes; 2 (8%) developed a localized traction retinal detachment not warranting additional surgery. Derangement in intraocular pressure was common (13 [54%] eyes). Three eyes (13%) showed signs of phthisis preoperatively that resolved with reestablishment of normal intraocular pressure postoperatively.

CONCLUSIONS: Temporary KP during PPV/PKP surgery allowed surgical intervention in eyes with complex anterior and posterior segment disease. Corneal graft clarity and successful retinal reattachment was possible in the majority of eyes.