ABSTRACT NUMBER - 0905

GLAUCOMA MANAGEMENT IN TYPE I BOSTONKERATOPROSTHESIS; MOORFIELDS EXPERIENCE2011Ð2014


Nicholas Strouthidis, Hari Jayaram,Michael O’Gallager, Matthew Green, Mark Wilkins

Meeting:  2014 RANZCO


SESSION INFORMATION

Date: 23 Nov 2014

Session Title: FREE PAPERS

Session Time: 4:00 pm - 5:30 pm

Purpose:
To describe the glaucoma management inpatients who have undergone implantation of the TypeI Boston Keratoprosthesis (KPro) at Moor?elds EyeHospital.

Method:
Retrospective note review of NHS (public)patients undergoing KPro procedures 2011–2014.

Results:
26 patients underwent KPro implantationunder the care of a single corneal consultant (MW). 11(42%) had pre-existing glaucoma, 6 (23%) had pre-existing functioning anterior chamber Baerveldt tubesand a further 3 had pars plana Baerveldts implantedeither before, during or after KPro surgery. One patientwith pre-existing Baervledt went blind from funneldetachment. A further 2 had undergone previous glau-coma surgeries (multiple diodes or trabeculectomies)and lost vision from disc progression post-KPro. Ofthe 15 without pre-existing glaucoma, 1 was lost tofollow-up and 1 KPro extruded and was replaced witha penetrating keratoplasty. 8 (31%) remain off drops,and 3 have required tube implantation. Of the latter 3,one went blind because of refractory high IOP.

Conclusion:
KPro surgery has the potential to giveuseful sight to patients in whom there are no otherviable options. However, many of these patients havecomplex multiple ophthalmic pathologies, which maketheir post-operative management dif?cult and can leadto poor outcomes in some cases. It is important to havean integrated management plan, particularly for glau-coma management. In light of our experience, we haveestablished a combined glaucoma/KPro clinic in thehope of managing potential glaucoma problems aprioriand to establish the best methods of monitoring thesepatients after KPro implantation.

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