Combined anterior and posterior segments surgery using temporary keratoprosthesis for severe ocular injuries

Abstract

Objective To compare the effectiveness of combined vitrectomy with penetrating keratoplasty using temporary keratoprosthesis for different types of severe ocular injuries. Method 20cases (21eyes) including 11 ocular explosive injuries and 9 ocular penetrating injuries were underwent combined surgery .The preoperative visual acuity was from light perception to hand movement. With temporary keratoprosthesis pars plana vitrectomy, cataract excision, foreign body removal ,reattachment of retina and partial penetrating keratoplasty was performed .The follow-up period was from 3～36 months, the mean follow-up time was 17 months. Analysis was focused on visual acuity (VA), intraocular pressure, anatomic results and complications. Result 19 eyes including 100% ocular explosive injuries and 78% ocular penetrating injuries retained anatomic integrity of eyeball. 11 cases (52%) got the final postoperative VA 0.05 or better, 9 eyes were explosive injuries, the other 2 eyes were penetrating injuries. The severe complications including intraocular hypotension and retinal redetachment were all occurred in the cases with ocular penetrating injuries. Conclusion Temporary keratoprosthesis used in the combined surgeries of anterior and posterior ocular segments is proved to be an unique effective method for treatment of severe ocular injuries.Prognosis of ocular explosive injuries is better than ocular penetrating injuries. Key words: Ocular trauma; Combined surgery; Temporary keratoprosthesis