[Outcome of combined penetrating keratoplasty with vitreoretinal surgery using temporary Eckardt keratoprosthesis].

BACKGROUND

For the adequate management of vitreoretinal pathology, good visualization through a clear cornea is needed to permit proper surgical repair. However, an opaque cornea, precludes this necessary visualization and makes posterior segment surgery impossible. Temporary keratoprosthesis facilitates visualization of intraocular structures in eyes that might otherwise be inoperable due to corneal opacities.

AIM

To report the effectiveness of a combined procedure (pars plana vitrectomy with temporary Eckardt keratoprosthesis, vitreoretinal surgery, and penetrating keratoplasty) and to assess the functional outcome of eyes undergoing these procedures.

METHODS

Six eyes from six consecutive patients operated on between 2001 and 2004 at the Department of Ophthalmology, Soroka University Medical Center, Beer Sheva, and followed-up for at least 6 months, were evaluated retrospectively. The evaluation focused on ocular history, visual acuity (VA), anatomical outcome and complications.

RESULTS

The average follow-up period was 26 months. Prior to the operation, the most frequent diagnosis in the anterior segment was corneal scar in 4 eyes (67%). In the posterior segment, the most frequent diagnosis was retinal detachment in 5 eyes (83%). Preoperative VA was full light perception or less in all eyes. In five cases (83%), final postoperative VA was 6/240 or better. The corneal graft remained clear in five cases (83%). The retina remained attached in all cases.

CONCLUSIONS

Combined corneal and retinal procedures using temporary keratoprosthesis are a safe and efficacious way of managing complicated corneal and retinal disease. These methods can preserve ambulatory vision and improve the quality of life of patients. Visual prognosis is usually limited due to the primary ocular disease.