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. 2015:2015:163675.
doi: 10.1155/2015/163675. Epub 2015 Nov 4.

Wide-Field Landers Temporary Keratoprosthesis in Severe Ocular Trauma: Functional and Anatomical Results after One Year

Katarzyna Nowomiejska  1 , Dariusz Haszcz  1 , Cesare Forlini  2 , Matteo Forlini  3 , Joanna Moneta-Wielgos  1 , Ryszard Maciejewski  4 , Tomasz Zarnowski  5 , Anselm G Juenemann  6 , Robert Rejdak  7
Affiliations

Wide-Field Landers Temporary Keratoprosthesis in Severe Ocular Trauma: Functional and Anatomical Results after One Year

Katarzyna Nowomiejska et al. J Ophthalmol. 2015.

Abstract

Purpose. To evaluate longitudinal functional and anatomical results after combined pars plana vitrectomy (PPV) and penetrating keratoplasty (PKP) using a wide-field Landers intraoperative temporary keratoprosthesis (TKP) in patients with vitreoretinal pathology and corneal opacity due to severe ocular trauma. Material and Methods. Medical records of 12 patients who had undergone PPV/PKP/KP due to severe eye trauma were analyzed. Functional (best-corrected visual acuity) and anatomic outcomes (clarity of the corneal graft, retinal attachment, and intraocular pressure) were assessed during the follow-up (mean 16 months). Results. Final visual acuities varied from NLP to CF to 2 m. Visual acuity improved in 7 cases, was unchanged in 4 eyes, and worsened in 1 eye. The corneal graft was transparent during the follow-up in 3 cases and graft failure was observed in 9 eyes. Silicone oil was used as a tamponade in all cases and retina was reattached in 92% of cases. Conclusions. Combined PPV and PKP with the use of wide-field Landers TKP allowed for surgical intervention in patients with vitreoretinal pathology coexisting with corneal wound. Although retina was attached in most of the cases, corneal graft survived only in one-fourth of patients and final visual acuities were poor.

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Figures

Figure 1
Figure 1
Original Landers PMMA keratoprosthesis (left), wide-field Landers PMMA keratoprosthesis (middle), and Eckart silicone keratoprosthesis (right). Picture from a book by Narendran et al. [5].
Figure 2
Figure 2
Extended corneal laceration (zone II) with iris and vitreous prolapse due to penetrating trauma: case number 3.
Figure 3
Figure 3
Retinal detachment seen in ultrasonography in patient with corneal laceration.
Figure 4
Figure 4
Sutured corneal wound during an emergency operation.
Figure 5
Figure 5
Trephining the cornea during combined vitrectomy/penetrating keratoplasty/temporary keratoprosthesis surgery.
Figure 6
Figure 6
Wide-field temporary keratoprosthesis sutured to the corneal bed using six Vicryl sutures.
Figure 7
Figure 7
Internal limiting membrane peeling visualized through the temporary keratoprosthesis after dying with indocyanine green during vitrectomy.
Figure 8
Figure 8
The eye after one month of the follow-up after combined surgery, clear corneal graft.
Figure 9
Figure 9
Graft failure after one year of the follow-up after combined surgery.
See this image and copyright information in PMC

References

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