Clinical Outcome of Early Combined Vitreoretinal Surgery Using Temporary Keratoprosthesis Followed by Penetrating Keratoplasty in Severe Blast Injury Patients

Torabi, Hamidreza; Bahrami Far, Ali; Jadidi, Khosrow; Daryabari, Seyed-hashem

doi:10.30491/tm.2024.397335.1597

Clinical Outcome of Early Combined Vitreoretinal Surgery Using Temporary Keratoprosthesis Followed by Penetrating Keratoplasty in Severe Blast Injury Patients

Document Type : Original Article

Authors

Hamidreza Torabi ¹

Ali Bahrami far ²

Khosrow Jadidi ³

Seyed-hashem Daryabari ⁴

¹ Associate Professor of Ophthalmology, Health Management Research Centre, Baqiyatallah University of Medical Sciences, Tehran, Iran.

² Assistant Prof. of Anesthesiology, Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

³ Department of Ophthalmology, Baqiyatallah University of Medical Sciences, Tehran, Iran.

⁴ Assistant Prof. of Ophthalmology, Chemical Injury Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

10.30491/tm.2024.397335.1597

Abstract

Introduction: This study aimed to assess the clinical outcome of combined pars plana deep vitrectomy (PPV) with temporary keratoprosthesis and penetrating keratoplasty (PK) in severe military ocular trauma patients.
Methods: During 12 months of follow-up, 13 eyes of 12 patients operated on from September 2017 to March 2018 were evaluated. Ocular history, visual acuity (VA), and clinical findings of the cornea and retina were recorded.
Results: Twelve patients with severe military ocular trauma and light perception VA were included. At the end of the visit, 66.5% of the patients had better visual acuity; the cornea remained clear in 50%, and the retina was attached in 91.6% of the eyes. The rate of additional surgery was 25% of cases due to corneal graft failure.
Conclusion: The long-term results of combined PPV with PK in eyes that would otherwise be untreatable due to severe injury are often limited by secondary graft failure. Although the clinical outcomes are not very satisfactory in the long term, the combined surgery gives these patients these patients the last chance to conserve their remaining vision and undergo anatomic reconstruction.

Keywords

Ocular Trauma

Pars Plana Vitrectomy

Temporary Keratoprosthesis

Penetrating Keratoplasty

Subjects