Neurotrophic Keratopathy Following Pars Plana Vitrectomy and Indirect Ophthalmoscopic Laser
Narrative Responses:
Purpose
Retrospective chart review was completed on all patients diagnosed with neurotrophic keratopathy from 1/2007 to 3/2012 at a single cornea practice.
Methods
Retrospective chart review was completed on all patients diagnosed with neurotrophic keratopathy from 1/2007 to 3/2012 at a single cornea practice. Patients were identified by search of electronic medical records for neurotrophic keratoconjunctivitis. Inclusion criteria was diagnosis of neurotrophic keratopathy, age > 18 years, follow-up greater than 1 day. 17 patients were identified, 1 excluded due to no follow-up; analysis was based on 19 eyes from 16 patients. Treatment included tears, antibiotics, cyclosporine, punctal plugs, and bandage contact lens. Outcome measurements were based on risk factors identified, number of treatment modalities used, and final visual acuity.
Results
Final results showed that 74% of patients had traditional risk factors. Of the 26% remaining without traditional risk factors, all had undergone pars plana vitrectomy and IDOL within 6 months of presentation. The groups were divided based on those who had received recent retinal surgery and those that had not. The p-value indicating retina surgery as a risk factor was 0.20, and the p-value comparing the number of treatment modalities required between the two groups was 0.27. In comparing the final visual acuity between the two groups, the p-value was 0.20.
Conclusion
Pars plana vitrectomy with panretinal photocoagulation may be an unrecognized cause of neurotrophic keratopathy. Patients who had undergone PPV/IDOL recovered well with conservative therapy