Long-term effect of combined penetrating keratoplasty and pars plana vitrectomy with temporary keratoprosthesis

Abstract

To evaluate the long-term effect of combined penetrating keratoplasty, pars plana vitrectomy and temporary keratoprosthesis for the treatment of complicated anterior and posterior segment diseases. Combined penetrating keratoplasty and pars plana vitrectomy were performed in 107 eyes with temporary keratoprosthesis. The mean follow-up period was 13 months. Visual acuity, graft transparency, intraocular pressure and vitreoretinal anatomic status were examined during the follow-up. The criteria of success of the operation included a transparent graft, reattached retina and normal intraocular pressure with or without medication. Ninety-two eyes. 86.0%) could be preserved after the operation, including 78 eyes (72.9%) with clear graft, reattached retina and normal intraocular pressure. Graft rejection occurred in 34 eyes (31.8%), atrophy of the eye in 13 eyes (12.2%) and secondary glaucoma in 15 eyes (14.0%). The success rate for re-attachment of the retina was higher in eyes without pre-operative proliferative vitreoretinopathy. Combined penetrating keratoplasty and pars plana vitrectomy with temporary keratoprosthesis appear to be effective in the treatment of severe ocular injury. Decompensation of corneal endothelium function and proliferative vitreoretinopathy are the main causes for failure of the operation.