TY - JOUR
T1 - Long-term complications associated with glaucoma drainage devices and boston keratoprosthesis
AU - Li, Jennifer
AU - Greiner, Mark A.
AU - Brandt, James D
AU - Lim, Michele C
AU - Mannis, Mark J
PY - 2011/8
Y1 - 2011/8
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=79960835973&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79960835973&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2011.01.034
DO - 10.1016/j.ajo.2011.01.034
M3 - Article
C2 - 21636070
AN - SCOPUS:79960835973
VL - 152
SP - 209
EP - 218
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
IS - 2
ER -