Article Text

PDF
Keratoprostheses in silicone oil-filled eyes: long-term outcomes
  1. Geetha Iyer1,
  2. Bhaskar Srinivasan1,
  3. Shweta Agarwal1,
  4. Ruchika Pattanaik1,
  5. Ekta Rishi2,
  6. Pukhraj Rishi2,
  7. Shanmugasundaram Shanmugasundaram3,
  8. Viswanathan Natarajan4
  1. 1 CJ Shah Cornea Services/Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
  2. 2 Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
  3. 3 Department of Oral & Maxillofacial Surgery, SRM Dental College, Chennai, Tamil Nadu, India
  4. 4 Department of Preventive Ophthalmology, Sankara Nethralaya, Chennai, Tamil Nadu, India
  1. Correspondence to Dr Geetha Iyer, CJ Shah Cornea Services/Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, Medical Research Foundation, Sankara Nethralaya, Chennai, TN 600 006, India; drgeethaiyer{at}gmail.com

Abstract

Purpose To analyse the functional and anatomical outcomes of different types of keratoprostheses in eyes with retained silicone oil following vitreoretinal surgery.

Methods Retrospective chart review of patients operated with any type of permanent keratoprosthesis (Kpro) in silicone oil-filled eyes between March 2003 and June 2017 were analysed.

Results 40 silicone oil-filled eyes underwent keratoprostheses, of which 22 were type 1 and 18 were type 2 Kpros (Lucia variant—nine, modified osteo odonto kerato prosthesis (MOOKP)—four, Boston type 2—three and osteoKpro—two) with a mean follow-up of 61.54 , 42.77, 45.25 , 25 and 37 months, respectively. Anatomic retention of the primary Kpro was noted in 33 eyes (82.5%). A best-corrected visual acuity of better than 20/200 and 20/400 was achieved in 26 (65%)+32 (80%) eyes. Retroprosthetic membrane (RPM) was the most common complication noted in 17 eyes (42.5%). Perioptic graft melt was noted in 4 of 22 eyes of the type 1 Kpro (2 (10.5%) without associated ocular surface disorder (OSD)) and in 1 eye each of Boston and Lucia type 2 Kpro. Laminar resorption occurred in one eye each of the MOOKP and OKP groups. Endophthalmitis and glaucoma did not occur in any eye.

Conclusion Appropriately chosen keratoprosthesis is a viable option for visual rehabilitation in eyes post vitreoretinal surgery with retained silicone oil-induced keratopathy not amenable to conventional penetrating keratoplasty. Kpro melt among type 1 Kpro did not occur in 89.5% eyes without associated OSD (19 of 22 eyes), despite the lack of aqueous humour and presence of RPM (4 eyes), two factors considered to play a significant role in the causation of sterile melts. Of interest to note was the absence of infection in any of these eyes. The possible protective role of oil from endophthalmitis is interesting, though yet to be ascertained.

  • keratoprosthesis
  • retinal detachment
  • ocular hypotony
  • silicone oil
  • boston keratoprosthesis
  • OOKP
  • Kpro
View Full Text

Statistics from Altmetric.com

Footnotes

  • Contributors GI, BS and SA designed the study, provided the material, analysed and interpreted the data, wrote, proofed and revised the article. RP analysed and interpreted the data ER, PR and SS provided the material and proofed the article VN provided the statistical analysis.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Approval of the Institutional Review Board was obtained for this study which adhered to the tenets of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • At a glance
    Keith Barton James Chodosh Jost B Jonas