Glaucoma Surgery in Boston Type 1 Keratoprothesis Patients at the University of Montreal Hospital Center

Friday, April 17, 2015
KIOSKS (San Diego Convention Center)
Salima I. Hassanaly, MD
Kinda Najem, MD
Samuel Levallois, MD
Younes Agoumi, MD
Mona Harissi-Dagher, MD
Michael Marchand

Purpose
To evaluate glaucoma progression and the role of glaucoma surgery in Boston type 1 keratoprosthesis (KPro) patients.

Methods
A retrospective study of all KPro-implanted patients (117 eyes in 101 patients) between October 2008 and May 2014 in a university center. All eyes were included and comparatively evaluated: patients with glaucoma surgery prior to KPro (group 1; n=23 eyes), patients with glaucoma surgery post KPro (group 2; n=23 eyes), and KPro patients without glaucoma
surgery (group 3; n=49 eyes). KPro-implanted eyes without a diagnosis of glaucoma (group 4; n=22) were also examined. Outcome measures examined included visual acuity (VA), intraoperative and postoperative complications, intraocular pressure (IOP), optic nerve
status (cup-to-disc ratio, C/D), and glaucoma management.

Results
Glaucoma prevalence was 65.8% before KPro and de novo prevalence was 16.2% after KPro. Mean follow-up time was 42.7 months. At 12, 18, and 24 months postoperatively, group 2 had significantly better VA than group 3 (p=0.0131, p=0.0101, and p=0.0021 respectively). At 12 and 24 months, IOP in group 2 was significantly higher than in group 3 (p=0.0502, and p=0.0227), with glaucoma surgery taking place at a mean of 21.8 months. At 24 and 36
months, C/D ratios for group 3 were significantly lower than group 1 (p=0.0005 and, p=0.0058).

Conclusion
This cohort suggests that early glaucoma surgery post KPro implantation may be of benefit.